First person receives Pfizer Covid-19 vaccine in UK(bbc.com)
bbc.com
First person receives Pfizer Covid-19 vaccine in UK
https://www.bbc.com/news/uk-55227325
402 コメント
1) BMJ is rabble-rousing. Endpoints for any pivotal trial will be agreed with regulators in advance. In this case, while I don’t know the numbers themselves, I suspect that given the low rate of serious complications of Covid overall, waiting for sufficient numbers of outcomes such as hospitalisation, intensive care visits, or death, would increase the duration, size, and cost of the trial, and maybe significantly so.
2) Bitching about skipping the peer-review process in the face of a global pandemic is self-important nonsense. Peer review isn’t necessary for the drug approval process, and takes a significant amount of time and effort that the people involved probably didn’t have. If it’s between writing a regulatory submission versus a manuscript, in this situation prioritising the activity that will likely directly save lives is reasonable. The manuscripts and ever-so-important peer review will follow soon.
2) Bitching about skipping the peer-review process in the face of a global pandemic is self-important nonsense. Peer review isn’t necessary for the drug approval process, and takes a significant amount of time and effort that the people involved probably didn’t have. If it’s between writing a regulatory submission versus a manuscript, in this situation prioritising the activity that will likely directly save lives is reasonable. The manuscripts and ever-so-important peer review will follow soon.
> Bitching about skipping the peer-review process in the face of a global pandemic is self-important nonsense.
Making results available to peers is the basis of science, which is a short word that means being sure things work as we think they do.
Without peer review, no one has any idea of what the vaccine does.
What if the vaccine is nothing but a big old placebo? How can we tell?
It's far more than mere "bitching". Way more than that. The Royal Society's motto is 'Nullius in verba', which means "take nobody's word for it". Think about it.
Of all places to hear that blend of anti-science, I wasn't expecting to read it here.
Making results available to peers is the basis of science, which is a short word that means being sure things work as we think they do.
Without peer review, no one has any idea of what the vaccine does.
What if the vaccine is nothing but a big old placebo? How can we tell?
It's far more than mere "bitching". Way more than that. The Royal Society's motto is 'Nullius in verba', which means "take nobody's word for it". Think about it.
Of all places to hear that blend of anti-science, I wasn't expecting to read it here.
I can assure you it’s not being anti-science – it’s probably about a deeper understanding of how these things actually work.
> Without peer review, no one has any idea of what the vaccine does. What if the vaccine is nothing but a big old placebo? How can we tell?
This is what the regulatory authorities do. The FDA, the EMA, the MHRA, and many others. It is literally their job (amongst others) to make decisions on whether to approve drugs based on the data that they are provided with.
The process of publishing data in a peer-reviewed journal is orthogonal to this. Sure, it’s an important part of the scientific process, but it is not part of the process to decide whether or not drugs work and should be approved.
The only point that was being made is that in this sort of situation where delaying a few days means more people die, prioritising the regulatory approval process over submissions to a peer reviewed journal (if indeed that’s what happened) is entirely reasonable.
> Without peer review, no one has any idea of what the vaccine does. What if the vaccine is nothing but a big old placebo? How can we tell?
This is what the regulatory authorities do. The FDA, the EMA, the MHRA, and many others. It is literally their job (amongst others) to make decisions on whether to approve drugs based on the data that they are provided with.
The process of publishing data in a peer-reviewed journal is orthogonal to this. Sure, it’s an important part of the scientific process, but it is not part of the process to decide whether or not drugs work and should be approved.
The only point that was being made is that in this sort of situation where delaying a few days means more people die, prioritising the regulatory approval process over submissions to a peer reviewed journal (if indeed that’s what happened) is entirely reasonable.
Peer review is the specific process of sending your well edited manuscript to a select few reviewers of a journal in order to get that manuscript published in that journal.
It is different from having your results available to your peers, which I'm not sure they did that here, but point being peer review is this specific time consuming process (that can take months, sometimes years).
It is different from having your results available to your peers, which I'm not sure they did that here, but point being peer review is this specific time consuming process (that can take months, sometimes years).
You are picking on one point out of many. Anyway, I think I would sleep better just knowing that they published everything, even if it doesnt get the formal peer review.
The FDA released today all the data they're using for the upcoming Dec 10th discussion, and it is quite detailed:
https://www.fda.gov/media/144245/download
Writing a peer-reviewed paper two weeks after the data are out is hard, even more so when you have an emergency use authorization ongoing (which requires far more data).
https://www.fda.gov/media/144245/download
Writing a peer-reviewed paper two weeks after the data are out is hard, even more so when you have an emergency use authorization ongoing (which requires far more data).
Publication in a peer reviewed journal can take a lot of time, and I don't think that should be required in an urgent situation like this. Though of course the trials should still be reviewed somehow.
> ...but none of the phase III trials have been published in peer reviewed journals or analysed by age group, gender and case description...
What’s this then?
https://twitter.com/wgibson/status/1336298050315313158?s=21
What’s this then?
https://twitter.com/wgibson/status/1336298050315313158?s=21
N.B. Oxford have since published[0] a peer-reviewed study of phase 3 trial in The Lancet.
[0] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
[0] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
Why is this downvoted? These are valid concerns with respectable citations.
I work here and was in clinic this morning. We had three eligible patients. One consented to it and is having the vaccine now. The other two declined. Not making a point, just a data point.
Same thing happening on this side of the pond. It's been reported that approximately 50% of Americans say they definitely or probably would refuse a vaccine [1]. And the trend over time is more and more are planning to refuse.
Seems fitting that in a place where we can't beat the virus because of people who refuse to distance and wear a piece of cloth over their face, it's possible we won't even be able to beat it with a vaccine... because of the same assholes.
1: https://www.pewresearch.org/science/2020/09/17/u-s-public-no...
Seems fitting that in a place where we can't beat the virus because of people who refuse to distance and wear a piece of cloth over their face, it's possible we won't even be able to beat it with a vaccine... because of the same assholes.
1: https://www.pewresearch.org/science/2020/09/17/u-s-public-no...
Outright refusing the vaccine is absurd, but refusing at this phase of the distribution is not.
A lot of people are slightly skeptical/worried about the safety here in the UK. These aren't anti-vaxxers. More 'you first'.
That is definitely true, but the link seems to be from September and talks about refusing a vaccine in general, not this particular at this time.
50% is insane. 5% I'd be able to understand, but not 50%.
50% is insane. 5% I'd be able to understand, but not 50%.
> 50% is insane. 5% I'd be able to understand, but not 50%.
I'm hardly anti-vaxxer, but I'm going to wait this one out until a lot of people went head-first into it.
I take my vaccines like I take my software upgrades: no pre-releases of system-critical ones.
I'm hardly anti-vaxxer, but I'm going to wait this one out until a lot of people went head-first into it.
I take my vaccines like I take my software upgrades: no pre-releases of system-critical ones.
It's a little hard to obtain accurate data now about what people will potentially do in the future when faced with more information.
Sometimes it really sounds like there are people who just want everybody to die.
Something completely different that I just can't help thinking about this year:
I used to play Warhammer as a kid, and that game world has 4 forces of Chaos that threaten to tempt and corrupt people: Khorne was about violence and bloodshed, Slaanesh about kinky sex, Tzeentch about secret power, and Nurgle about disease and decay. I could understand the attraction of the other 3, but how Nurgle could be tempting to anyone was beyond me. Yet in our world, it looks like Nurgle is doing surprisingly well.
Something completely different that I just can't help thinking about this year:
I used to play Warhammer as a kid, and that game world has 4 forces of Chaos that threaten to tempt and corrupt people: Khorne was about violence and bloodshed, Slaanesh about kinky sex, Tzeentch about secret power, and Nurgle about disease and decay. I could understand the attraction of the other 3, but how Nurgle could be tempting to anyone was beyond me. Yet in our world, it looks like Nurgle is doing surprisingly well.
I always find it weird that sex gets equated to other negative things like this. Same for TV/film ratings. And yet these days, even kinky sex, is pretty low risk.
The risk of rape or other non consensual act or blackmail in kinky sex is not low. Most aint gonna call cops and people know it.
Define kinky? For some kinky is wearing leather, for some rolling in jelly, for some fake forced sex, etc. It's really not one bag and not the same risk. (Kind of like when people say "in Europe")
One could also make the argument that to be participating in "kinky sex" in the first place a person probably has thought more about sex than the average person and may have more experience communicating what they do and don't like - making verbal consent and discussions around these topics more likely to have happened.
It does not matter how clearly you communicated what you like, if the person you are with decided it is more fun for him/her to ignore your wish. And in worst case, if you allowed that person to tie you, you really cant do much. And afaik, that is real risk in those encounters.
Plus, people are ashamed to tell cops they participated on kinky sex, because they dont want that part of their sex life public. Meaning abusers have ideal situation in a lot of ways.
Plus, people are ashamed to tell cops they participated on kinky sex, because they dont want that part of their sex life public. Meaning abusers have ideal situation in a lot of ways.
Interesting. Thanks for sharing the anecdote. Seems odd to me you are asking people. Isn't there a line or something?
My biggest concern with virus rollout is millions of doses sitting on shelves waiting for "high priority" people to get them (who refuse) while "low priority" people are still banned from getting.
My biggest concern with virus rollout is millions of doses sitting on shelves waiting for "high priority" people to get them (who refuse) while "low priority" people are still banned from getting.
isn't there a priority list? If people refuse it should go to the next one
Yes the priorities are the over 80s, any spare slots are being given to the most-at-risk clinical groups (i.e. guessing ITU, A+E, resp and ENT). They reported internally that they administered 'dozens' today, so less than a hundred. There are some real logistical issues and it's not felt that other local centres will be able to provide it yet. It's clearly going to take a while to get this vaccine out.
No there's not a line, in this weather I don't think that'd be a good idea, and it'd likely be chaotic. These patients are attending hospital anyway for follow-up, so since they are here they are being vaccinated.
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If they don't want it, I'm more than happy to fly to the UK to get it.
Hong Kong doesn't seem to want to vaccinate most people before 2022
https://www.scmp.com/news/hong-kong/health-environment/artic...
Hong Kong doesn't seem to want to vaccinate most people before 2022
https://www.scmp.com/news/hong-kong/health-environment/artic...
Wow.
I suppose that's one way of keeping protesters off the streets.
the pfizer vaccine doesn't prevent infection, but does save lives by preventing severe symptoms, which is why at-risk groups are prioritized. the vaccines that actually prevent infection are still being developed. 2022 sounds realistic for that, if not a tad early.
> doesn't prevent infection
My understanding is not that it doesn't, just that this hasn't been proven yet.
My understanding is not that it doesn't, just that this hasn't been proven yet.
What do you mean it "doesn't prevent infection"? Trials showed vastly reduced infection rate amongst people who'd had the vaccine.
It prevented symptomatic covid, but we still don't know if it prevents transmission of the virus itself. It might just turn you into an asymptomatic spreader.
> Data are limited to assess the effect of the vaccine against transmission of SARS-CoV-2 from individuals who are infected despite vaccination. Demonstrated high efficacy against symptomatic COVID-19 may translate to overall prevention of transmission in populations with high enough vaccine uptake, though it is possible that if efficacy against asymptomatic infection were lower than efficacy against symptomatic infection, asymptomatic cases in combination with reduced mask-wearing and social distancing could result in significant continued transmission. Additional evaluations including data from clinical trials and from vaccine use post-authorization will be needed to assess the effect of the vaccine in preventing virus shedding and transmission, in particular in individuals with asymptomatic infection.
What they are saying is that it is technically possible for their vaccine which is highly effective at preventing symptomatic COVID to be somehow ineffective at preventing asymptomatic COVID.
https://www.fda.gov/media/144245/download
What they are saying is that it is technically possible for their vaccine which is highly effective at preventing symptomatic COVID to be somehow ineffective at preventing asymptomatic COVID.
https://www.fda.gov/media/144245/download
Huh, you're correct, at least in the case of Pfizer. That's a pretty important bit of info that seemed to be missing in all the reporting I'd read until I googled for that specifically.
I'd be surprised if it turned out that the vaccine simply dials down the symptoms, based on my understanding of vaccines, but I guess we can't rule it out yet.
I'd be surprised if it turned out that the vaccine simply dials down the symptoms, based on my understanding of vaccines, but I guess we can't rule it out yet.
What? This is the first I heard of this.
The Pfizer vaccine is the mRNA vaccine. And it doesn’t prevent you from getting sick.
But it might turn you into an asymptomatic spreader?
Oh great. Do you have sources?
This thing is going to turn us all into walking zombies. LOL.
The Pfizer vaccine is the mRNA vaccine. And it doesn’t prevent you from getting sick.
But it might turn you into an asymptomatic spreader?
Oh great. Do you have sources?
This thing is going to turn us all into walking zombies. LOL.
> Oh great. Do you have sources?
The trial simply didn't test for the effect the vaccine has on transmission, so the theory hasn't been disproven.
The trial simply didn't test for the effect the vaccine has on transmission, so the theory hasn't been disproven.
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As a layperson I read “prevent” to mean a 100% reduction. Not sure if there’s a slightly different interpretation than that but I’d presume that’s what they mean?
Didn't have a link handy at the time. Read this https://www.forbes.com/sites/williamhaseltine/2020/09/23/cov...
"We all expect an effective vaccine to prevent serious illness if infected. Three of the vaccine protocols—Moderna, Pfizer, and AstraZeneca—do not require that their vaccine prevent serious disease only that they prevent moderate symptoms which may be as mild as cough, or headache."
"Prevention of infection is not a criterion for success for any of these vaccines. In fact, their endpoints all require confirmed infections and all those they will include in the analysis for success, the only difference being the severity of symptoms between the vaccinated and unvaccinated."
"We all expect an effective vaccine to prevent serious illness if infected. Three of the vaccine protocols—Moderna, Pfizer, and AstraZeneca—do not require that their vaccine prevent serious disease only that they prevent moderate symptoms which may be as mild as cough, or headache."
"Prevention of infection is not a criterion for success for any of these vaccines. In fact, their endpoints all require confirmed infections and all those they will include in the analysis for success, the only difference being the severity of symptoms between the vaccinated and unvaccinated."
The Moderna vaccine, for example, “is highly effective in preventing symptomatic COVID.”
They only did PCR testing on trial participants who reported symptoms. They did not PCR test the entire study population.
Incidence of symptomatic COVID was dramatically halted by about Day 14 after the first dose:
https://twitter.com/wgibson/status/1336298050315313158?s=21
They only did PCR testing on trial participants who reported symptoms. They did not PCR test the entire study population.
Incidence of symptomatic COVID was dramatically halted by about Day 14 after the first dose:
https://twitter.com/wgibson/status/1336298050315313158?s=21
>the only difference being the severity of symptoms between the vaccinated and unvaccinated
seems kind of wrong to me. The main difference they are hoping for is the number of cases of illness between the unvaccinated and vaccinated. If you get 100 cases in the unvaccinated group and 1 in the vaccinated it doesn't really matter if the symptoms are a bit better or worse.
seems kind of wrong to me. The main difference they are hoping for is the number of cases of illness between the unvaccinated and vaccinated. If you get 100 cases in the unvaccinated group and 1 in the vaccinated it doesn't really matter if the symptoms are a bit better or worse.
Aren't all the vaccines from all the companies designed as mRNA that teaches/instructs the body how to kill the virus ?
The pfizer vaccine is mRNA, so when it goes into a cell it will use the translation machinery to convert to protein and that gets presented to the immune system. The Oxford vaccine uses a non-reproductive adenovirus to introduce the RNA into the cell, with a similar result. I think the Oxford one won't have issues with storage. There are others that use recombinant protein from the virus.
Color me surprised if there ends up being an actual problem with demand for this vaccine.
As soon as vaccinated people start flaunting their freedom of movement, people will clamor to line up. The vaccine's scarcity will further magnify the desire to get vaccinated.
It's natural for the initial reaction to be skepticism. Nobody wants to be first, but as soon as the first cohorts get vaccinated and the media publish their nonplussed reactions, the lines will explode and we'll have the opposite problem: me-first.
As soon as vaccinated people start flaunting their freedom of movement, people will clamor to line up. The vaccine's scarcity will further magnify the desire to get vaccinated.
It's natural for the initial reaction to be skepticism. Nobody wants to be first, but as soon as the first cohorts get vaccinated and the media publish their nonplussed reactions, the lines will explode and we'll have the opposite problem: me-first.
>As soon as vaccinated people start flaunting their freedom of movement
That could be a big factor. At the moment there's nothing - no vaccination certificate that lets you fly easier or something like that. But it could be a big motivator if there was.
That could be a big factor. At the moment there's nothing - no vaccination certificate that lets you fly easier or something like that. But it could be a big motivator if there was.
The news report that both the first (Margaret Keenan, 90) and the second person (William Shakespeare, 81) were vaccinated at the same "University Hospital, Coventry." So it's not that only one person was vaccinated there? Are you reporting only about the people you're directly in charge of, three of which where eligible, and one accepted, but still there were more vaccinated today there?
That's what I read from GP's comment.
Yes, these were patients attending my clinic for other reasons. At any one time there are obviously several clinics running - I suspect the hospital will announce how many in total have been vaccinated at the end of the day.
Hey thanks for your comment.
Could you describe in more detail how the vaccines are currently being stored in your clinic?
How long does the vaccine can remain in room temperature, once taken out of clod storage.
How many doses have been allocated to your clinic and on an average how many patients do you foresee being vaccinated over a short period of time, let's say a month.
Also, are health workers also planning to get vaccinated soon, as they are on the frontline and among most vulnerable to infection.
Any other details you would like to share.
Thanks again.
Could you describe in more detail how the vaccines are currently being stored in your clinic?
How long does the vaccine can remain in room temperature, once taken out of clod storage.
How many doses have been allocated to your clinic and on an average how many patients do you foresee being vaccinated over a short period of time, let's say a month.
Also, are health workers also planning to get vaccinated soon, as they are on the frontline and among most vulnerable to infection.
Any other details you would like to share.
Thanks again.
I run a specialty clinic for a type of cancer, so it isn't specific for vaccination. However, patients >80 yrs who were attending in person were identified as eligible for the vaccine. They have attended elsewhere in the hospital to receive the vaccine, but my understanding is that it needs -80/70 for storage, and can be moved a total of 4 times before needing to be discarded. I'm afraid I do not know more. Maybe if I wasn't so busy in the clinic I would have read through the info sheets in more detail, but it's always a rush!
I've stated this is my worry with the BioNTech/Fosun vaccine - transporting it safely to Eastern Europe. They can't seem to transport frozen fish properly, I really hope they keep that vaccine in proper conditions, otherwise it'll be rendered useless...
It's likely the chain of custody for fish and critical medical supplies will be somewhat different.
I can only hope so. They could very well outsource it to the usual transportation companies, and there isn't much accountability tbh.
Oh well, if this one doesn't work, perhaps we can try again with the Oxford vaccine heh
Oh well, if this one doesn't work, perhaps we can try again with the Oxford vaccine heh
You know, thinking fish and vaccine are treated the same does not show smart understanding of region. Honestly, it shows not understanding it at all.
Not that vaccines are about to be flawless. But failure will be different.
Not that vaccines are about to be flawless. But failure will be different.
It travels in purpose-built shipping containers, so it shouldn't really matter what the trucker does.
https://www.cbsnews.com/news/covid-vaccine-pfizer-distributi...
> In order to get around that, Pfizer has developed specially built deep-freeze "suitcases" that can be tightly sealed and shipped even in non-refrigerated trucks.
https://www.fiercepharma.com/manufacturing/pfizer-designed-n... indicates they can hold temperature for ten days.
They'll likely include seals and simple sensors to detect temperature excursions; for example, my daughter's growth hormone comes with a little piece of plastic that turns permanently pink if it's not stored at the right temperature for a few minutes.
https://www.cbsnews.com/news/covid-vaccine-pfizer-distributi...
> In order to get around that, Pfizer has developed specially built deep-freeze "suitcases" that can be tightly sealed and shipped even in non-refrigerated trucks.
https://www.fiercepharma.com/manufacturing/pfizer-designed-n... indicates they can hold temperature for ten days.
They'll likely include seals and simple sensors to detect temperature excursions; for example, my daughter's growth hormone comes with a little piece of plastic that turns permanently pink if it's not stored at the right temperature for a few minutes.
Oh, very interesting. I'm mostly worried about last mile distribution, but yeah, they're not stupid, they took all the necessary measures.
Some details:
Vaccine storage and preparation
The Pfizer/BioNTech coronavirus vaccine has the most difficult storage requirements of all the COVID-19 vaccine candidates currently undergoing trials. Currently, it needs to be stored between -80 to -60°C and has a six-month expiry. Over time and with more data being collected this may change.(4)
The vaccine needs to be thawed (for approximately three hours in the fridge or 30 minutes at room temperature) before use and may be stored undiluted at 2–8°C for five days, or for two hours at 25°C prior to use.(4) To prepare the vaccine, it should be diluted using 0.8 mL of sodium chloride 0.9% solution for injection, marked with the date and time, and can then be stored between 2 to 25°C. It must be used within six hours or the remainder discarded.(4)
To equalise the pressure in the prepared vial, 1.8 mL of air should be withdrawn using the same syringe for preparation, after which it can be mixed by gently inverting 10 times, producing an off-white solution that is ready to be administered. The vaccines are available in packs of 195. There are five 0.3 mL doses within each vial.
In comparison, the Moderna vaccine can be stored at -20°C for up to six months, 30 days at 2 to 8°C and up to 12 hours at 25°C. Each vial contains 10 doses.
The AstraZeneca/Oxford vaccine is much simpler than both options, with storage allowance of 2 to 8°C for up to six months. Once open, the vials should be used within six hours stored in a fridge or 48 hours if at room temperature. They are delivered in packs of 10 vials with each vial containing eight or 10 doses of vaccine.
Vaccine storage and preparation
The Pfizer/BioNTech coronavirus vaccine has the most difficult storage requirements of all the COVID-19 vaccine candidates currently undergoing trials. Currently, it needs to be stored between -80 to -60°C and has a six-month expiry. Over time and with more data being collected this may change.(4)
The vaccine needs to be thawed (for approximately three hours in the fridge or 30 minutes at room temperature) before use and may be stored undiluted at 2–8°C for five days, or for two hours at 25°C prior to use.(4) To prepare the vaccine, it should be diluted using 0.8 mL of sodium chloride 0.9% solution for injection, marked with the date and time, and can then be stored between 2 to 25°C. It must be used within six hours or the remainder discarded.(4)
To equalise the pressure in the prepared vial, 1.8 mL of air should be withdrawn using the same syringe for preparation, after which it can be mixed by gently inverting 10 times, producing an off-white solution that is ready to be administered. The vaccines are available in packs of 195. There are five 0.3 mL doses within each vial.
In comparison, the Moderna vaccine can be stored at -20°C for up to six months, 30 days at 2 to 8°C and up to 12 hours at 25°C. Each vial contains 10 doses.
The AstraZeneca/Oxford vaccine is much simpler than both options, with storage allowance of 2 to 8°C for up to six months. Once open, the vials should be used within six hours stored in a fridge or 48 hours if at room temperature. They are delivered in packs of 10 vials with each vial containing eight or 10 doses of vaccine.
Interesting that you had three eligible patients - I wonder if that is repeated across the hospital, how many eligible inpatients are there likely to be out of each batch of vaccines?
It sounds like it might be a struggle to find enough people to give it to once each container is opened.
It sounds like it might be a struggle to find enough people to give it to once each container is opened.
These were patients attending for another reason. It's a large teaching hospital (1250 beds) with many patients attending for outpatients every day, so I'm sure there will be plenty of eligible patients to give the vaccine to.
I'd guess that people will be the most apprehensive at the very beginning but then will be more open to it as it goes along.
> Second in line for the jab at University Hospital in Coventry was 81-year-old William Shakespeare from Warwickshire
His high priority must've been on purpose, right?
His high priority must've been on purpose, right?
Taming of the flu.
Given that he was second in line... He was patient 2B (or not to be)?
Shamelessly stolen from Deutsche Welle :) https://www.dw.com/en/the-day-with-brent-goff-the-first-inje...
Shamelessly stolen from Deutsche Welle :) https://www.dw.com/en/the-day-with-brent-goff-the-first-inje...
Maybe it was to make up for being sent to Coventry.
I wonder if he was randomly determined to patient 1 for the vaccine, then they thought the conspiracy theorists will go nuts if they find out William Shakespear had the first shot
Typical, celebrities getting priority.
Gotta admire how good the vaccine is though, reviving the dead
Gotta admire how good the vaccine is though, reviving the dead
Ah, Warwickshire, the undiscovered country from whose bourn some travellers do apparently return.
To be ... or not to be (vaccinated!).
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As this rolls out I thought Derek Lowe had a good point to make
https://blogs.sciencemag.org/pipeline/archives/2020/12/04/ge...
When you vaccinate this many people, you will have those people die, get heart attacks, strokes, cancer, etc. Why? Because that would have happened to them anyways, vaccine or not.
So don’t freak out when “issues” start to crop up. Wait until someone has a done a proper analysis to see if the “issue” is actually related to the vaccine.
https://blogs.sciencemag.org/pipeline/archives/2020/12/04/ge...
When you vaccinate this many people, you will have those people die, get heart attacks, strokes, cancer, etc. Why? Because that would have happened to them anyways, vaccine or not.
So don’t freak out when “issues” start to crop up. Wait until someone has a done a proper analysis to see if the “issue” is actually related to the vaccine.
https://science.sciencemag.org/content/sci/370/6520/1022.ful...
'Public needs to prep for vaccine side effects, “Take Tylenol and suck it up,” says one researcher. Fever, aches show vaccine works'.
'Public needs to prep for vaccine side effects, “Take Tylenol and suck it up,” says one researcher. Fever, aches show vaccine works'.
Thanks for posting that article.
That article is going to be a bad one for convincing people. They overstate COVID lethality and downplay people's worries about the side effects.
If this article is representative of the public messaging on the vaccine people are going to start being hesitant to take it. We've already seen some of this.
They should instead be talking about the # of people to whom the vaccines have been given and compare their outcomes to accurate COVID stats. This is how I've worked with people who are nervous, but I don't actually have the vaccine trial outcomes (other than # who got COVID) because I don't think they have been published!
That article is going to be a bad one for convincing people. They overstate COVID lethality and downplay people's worries about the side effects.
If this article is representative of the public messaging on the vaccine people are going to start being hesitant to take it. We've already seen some of this.
They should instead be talking about the # of people to whom the vaccines have been given and compare their outcomes to accurate COVID stats. This is how I've worked with people who are nervous, but I don't actually have the vaccine trial outcomes (other than # who got COVID) because I don't think they have been published!
Seeing this post reminded me that when I had the 'flu vaccine a little while back, the Pharmacist advised avoiding Paracetamol (Tylenol?) afterwards in case it reduced the efficacy of the vaccine. A bit of quick Googling turned up study results from a while back suggesting this in relation to childhood vaccines. Just wondering if anyone here with experience in the field has a opinion on whether painkillers like these are best avoided for a short time afterwards.
Honestly Tylenol is a really fucky one, I've had it once when I was in the US and it got me off my tits. I mean pardon my french but that stuff is something else. And in a lot of cases gratuitous; at best it takes the edge off, for me personally, some paracetamol has the same effect without the side effects of an inability to drive or operate heavy machinery.
I'm not sure what you took, but plain Tylenol is paracetamol (acetaminophen). It sounds like you may have taken a Tylenol-branded compound medication that added an antihistamine or something like that (there are several acetaminophen-plus over-the-counter medications available).
Uhh, Tylenol = acetaminophen = paracetamol, it's all the same thing with different names.
Did you have one of the Tylenol XX formulations with other active ingredients mixed in, perhaps?
Did you have one of the Tylenol XX formulations with other active ingredients mixed in, perhaps?
It's possible you had a Tylenol 3 or 4 (or 1,2) which are paracetamol + codeine. Not the strongest painkiller but more than anything OTC.
Funny that covid deaths are diagnosed the other way around: even if you die WITH covid it's assumed that you died BECAUSE of covid.
But when it comes to the vaccine it should be the other way around? So we have to apply common sense to the vaccine related deaths but not to the covid related deaths?
But when it comes to the vaccine it should be the other way around? So we have to apply common sense to the vaccine related deaths but not to the covid related deaths?
Is this really true? I know that, at least here in Denmark, the relevant authority has sent out a note saying, explicitly, that dying of eg. a heart attack, while infected with COVID-19, does not count as a COVID-19 death. It also explicitly says the same thing about motor-cycle accidents, which I know has been a rumor that has made the rounds.
Source: https://sundhedsdatastyrelsen.dk/-/media/sds/filer/rammer-og...
Source: https://sundhedsdatastyrelsen.dk/-/media/sds/filer/rammer-og...
It's true in the UK. Anyone who dies with 28 days of testing positive for Covid-19 is counted as a Covid death, don't think there are exceptions for obvious things like motor-cycle accidents and definitely not for heart attacks (some of those probably are caused by Covid). Also, the NHS is testing almost everyone admitted to hospital. Used to be anyone who died at any point after testing positive but that messed with the figures too much and made it impossibe to see any actual increase in Covid deaths.
This is one of many reasons that it's difficult to compare death figures from different countries.
This is one of many reasons that it's difficult to compare death figures from different countries.
There are several different ways these figures are collected and reported.
As for the cause of death, FullFact has this to say:
When completing a death certificate, the responsible medical professional is asked to determine which conditions may have contributed to death. They are also asked to determine “the disease or injury that initiated the train of events directly leading to death” and this is called the “underlying cause”.[0]
So deaths that were caused by COVID-19 will be reported as such, and that's different from the number of people that died with COVID-19.
Note also that it's a criminal offence to knowingly report an incorrect cause of death on a death certificate.
[0] https://fullfact.org/health/causes-of-death-october-2020/
As for the cause of death, FullFact has this to say:
When completing a death certificate, the responsible medical professional is asked to determine which conditions may have contributed to death. They are also asked to determine “the disease or injury that initiated the train of events directly leading to death” and this is called the “underlying cause”.[0]
So deaths that were caused by COVID-19 will be reported as such, and that's different from the number of people that died with COVID-19.
Note also that it's a criminal offence to knowingly report an incorrect cause of death on a death certificate.
[0] https://fullfact.org/health/causes-of-death-october-2020/
In the UK there are 4 figures
1) Died within 28 days of a +ve test
2) Died within 60 days of a +ve test (in England, but not elsewhere)
3) Death certificate mentions covid
4) Excess deaths above that expected
Then there's the "date reported" and "date of death". The date reported is the day the notice reaches the death registrar. That can be within an hour or so of actual death, or can take months. Most are done within about 5 days.
For November, in the UK, there were an average
418 deaths occurred per day in the 28 day after a +ve test and 396 deaths reported
410 deaths per day on the death certificate
In England alone
28 days: 354 (occurred), 335 (reported)
60 days: 380 (occurred), 358 (reported)
Excess deaths: +251 (5 year average), +310 (vs minimum), +191 (vs maximum)
If the majority of those deaths were people being hit by a bus, you'd expect the 60 day number to be about double the 28 day number
1) Died within 28 days of a +ve test
2) Died within 60 days of a +ve test (in England, but not elsewhere)
3) Death certificate mentions covid
4) Excess deaths above that expected
Then there's the "date reported" and "date of death". The date reported is the day the notice reaches the death registrar. That can be within an hour or so of actual death, or can take months. Most are done within about 5 days.
For November, in the UK, there were an average
418 deaths occurred per day in the 28 day after a +ve test and 396 deaths reported
410 deaths per day on the death certificate
In England alone
28 days: 354 (occurred), 335 (reported)
60 days: 380 (occurred), 358 (reported)
Excess deaths: +251 (5 year average), +310 (vs minimum), +191 (vs maximum)
If the majority of those deaths were people being hit by a bus, you'd expect the 60 day number to be about double the 28 day number
> If the majority of those deaths were people being hit by a bus, you'd expect the 60 day number to be about double the 28 day number
Only if the testing was unrelated to the death or hospitalisation. If people who get hit by a bus are routinely tested in the ambulance or in hospital, the outcome will be more likely as reported.
Only if the testing was unrelated to the death or hospitalisation. If people who get hit by a bus are routinely tested in the ambulance or in hospital, the outcome will be more likely as reported.
Only if a significant number of the population test positive.
In November in England, 354 a day died with a positive test within 28 days. 1635 a day died anyway, meaning 1281 died without a positive test.
If 1% of the population were positive, that would mean 16 people would a day "die with covid".
To get 354 "with covid" deaths would require 20% of the country to test positive.
Mass lateral flow testing in Liverpool last month (Liverpool being hit far worse than most of the country) showed 0.6% of the population with covid. Reports were they were pretty bad flows, missing about half the actual cases, so lets say 1% actually had it.
That would mean that of 1635 people a day dying, 16 would "die with covid".
In November in England, 354 a day died with a positive test within 28 days. 1635 a day died anyway, meaning 1281 died without a positive test.
If 1% of the population were positive, that would mean 16 people would a day "die with covid".
To get 354 "with covid" deaths would require 20% of the country to test positive.
Mass lateral flow testing in Liverpool last month (Liverpool being hit far worse than most of the country) showed 0.6% of the population with covid. Reports were they were pretty bad flows, missing about half the actual cases, so lets say 1% actually had it.
That would mean that of 1635 people a day dying, 16 would "die with covid".
10 seconds Googling: https://cbs12.com/news/local/man-who-died-in-motorcycle-cras...
Many other stories like that
Many other stories like that
Maybe you should spend more than 10 seconds Googling?
You could, for example, read the story you linked, which states: "Despite health officials knowing the man died in a motorcycle crash, it is unclear whether or not his death was removed from the overall count in the state."
So it's a nothing story, with no statement of fact included at all. Just "unclear whether or not" against repeated statements by state officials that "not."
You could, for example, read the story you linked, which states: "Despite health officials knowing the man died in a motorcycle crash, it is unclear whether or not his death was removed from the overall count in the state."
So it's a nothing story, with no statement of fact included at all. Just "unclear whether or not" against repeated statements by state officials that "not."
So it was included and then removed once people noticed?
There will always be small numbers of cases of stupid coroners, clerical mistakes, etc. Finding one is not proof that there are hundreds of thousands.
We can rule out the "they're reporting everything as COVID and that's making the numbers high" hypothesis by looking at overall excess deaths - how many more deaths is the nation experiencing than is typical. A misdiagnosis won't affect excess deaths, as it counts all deaths, regardless of cause. The CDC provides a page for this:
https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
As is readily visible in the chart, we've been substantially over the norm since late March.
(Switch the chart to New York City for an even more obvious example of how a spike in excess deaths shows up. Screenshots: https://imgur.com/a/zSkNbxT)
We can rule out the "they're reporting everything as COVID and that's making the numbers high" hypothesis by looking at overall excess deaths - how many more deaths is the nation experiencing than is typical. A misdiagnosis won't affect excess deaths, as it counts all deaths, regardless of cause. The CDC provides a page for this:
https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
As is readily visible in the chart, we've been substantially over the norm since late March.
(Switch the chart to New York City for an even more obvious example of how a spike in excess deaths shows up. Screenshots: https://imgur.com/a/zSkNbxT)
Same for "long term COVID" - doesn't matter most symptoms can easily be explained by anxiety due to the amount of fearmongering. But definitely not for the vaccine side effects!
This isn't totally accurate for the guidance from CDC's National Center for Health Statistics:
https://www.cdc.gov/nchs/nvss/covid-19.htm#understanding-the...
In summary:
- COVID-19 deaths are counts of death certificates that list COVID-19 as a contributing cause of death.
- A death certificate can list multiple causes of death. The dataset I work with includes up to 20.
- Causes of death are determined by the medical professional who fills out the death certificate. They use their professional judgement.
- COVID-19 deaths are counted differently compared to usual death data. In the usual tables listing deaths by cause, each death is only counted for the underlying cause of death (there can be only one). That's the cause which kicked off the whole process of dying. Still, for the COVID-19 deaths, the disease must still be a contributing cause.
As a note, I don't believe any allegations the professionals filling out death certificates are following firm and unreasonable rules. The group of people who file death certificates in the US is just to varied: physicians, medical examiners, elected coroners, district attorneys, etc. Coordination, let alone conspiracy, is nearly impossible.
https://www.cdc.gov/nchs/nvss/covid-19.htm#understanding-the...
In summary:
- COVID-19 deaths are counts of death certificates that list COVID-19 as a contributing cause of death.
- A death certificate can list multiple causes of death. The dataset I work with includes up to 20.
- Causes of death are determined by the medical professional who fills out the death certificate. They use their professional judgement.
- COVID-19 deaths are counted differently compared to usual death data. In the usual tables listing deaths by cause, each death is only counted for the underlying cause of death (there can be only one). That's the cause which kicked off the whole process of dying. Still, for the COVID-19 deaths, the disease must still be a contributing cause.
As a note, I don't believe any allegations the professionals filling out death certificates are following firm and unreasonable rules. The group of people who file death certificates in the US is just to varied: physicians, medical examiners, elected coroners, district attorneys, etc. Coordination, let alone conspiracy, is nearly impossible.
I feel like mRNA vaccines have huge potential, but I am really, really concerned about potential side effects. Does anyone know which other helper-substances are inside the vaccine, besides the RNA?
Ingredients list:
>6. PHARMACEUTICAL PARTICULARS
>6.1 List of excipients
ALC-0315 = (4-hydroxybutyl) azanediyl)bis (hexane-6,1-diyl)bis(2-hexyldecanoate),
ALC-0159 = 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide,
1,2-Distearoyl-sn-glycero-3-phosphocholine,
cholesterol,
potassium chloride,
potassium dihydrogen phosphate,
sodium chloride,
disodium hydrogen phosphate dihydrate,
sucrose,
water for injections
Source is the pdf from this UK Gov page:
https://www.gov.uk/government/publications/regulatory-approv...
I have no idea at all about vaccines, healthcare or bio chem so please correct me but. ..
The first 2 are the RNA right?
Sodium and potassium chloride are standard in table salt and saline drips right?
Sucrose and cholesterol occur naturally in humans I think (sucrose comes from breaking down fructose?).
Potassium dihydrogen phosphate is harder. No real idea what that is, but apparently they put it in gatorade?
https://en.m.wikipedia.org/wiki/Monopotassium_phosphate
Disodium hydrogen phosphate dihydrate is (I think) also used in food (condensed milk) and water softeners!
Anyone know what 1,2-Distearoyl-sn-glycero-3-phosphocholine is? Or
I'm sort of impressed it doesn't have 1001 complex chemicals.
>6. PHARMACEUTICAL PARTICULARS
>6.1 List of excipients
ALC-0315 = (4-hydroxybutyl) azanediyl)bis (hexane-6,1-diyl)bis(2-hexyldecanoate),
ALC-0159 = 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide,
1,2-Distearoyl-sn-glycero-3-phosphocholine,
cholesterol,
potassium chloride,
potassium dihydrogen phosphate,
sodium chloride,
disodium hydrogen phosphate dihydrate,
sucrose,
water for injections
Source is the pdf from this UK Gov page:
https://www.gov.uk/government/publications/regulatory-approv...
I have no idea at all about vaccines, healthcare or bio chem so please correct me but. ..
The first 2 are the RNA right?
Sodium and potassium chloride are standard in table salt and saline drips right?
Sucrose and cholesterol occur naturally in humans I think (sucrose comes from breaking down fructose?).
Potassium dihydrogen phosphate is harder. No real idea what that is, but apparently they put it in gatorade?
https://en.m.wikipedia.org/wiki/Monopotassium_phosphate
Disodium hydrogen phosphate dihydrate is (I think) also used in food (condensed milk) and water softeners!
Anyone know what 1,2-Distearoyl-sn-glycero-3-phosphocholine is? Or
I'm sort of impressed it doesn't have 1001 complex chemicals.
The RNA isn't in that list. The first four are likely all components of the lipid vesicles that are used to deliver the mRNA. The rest of the list is mostly some salts and then sugar and water.
Thanks!
Any idea if thoseipid vesicles are "standard"?
In case you care, I have no objections to the vaccine. I'm too young (36 and not working in care) to get it any time soon. But I'd take it tomorrow if it were available for me.
Any idea if thoseipid vesicles are "standard"?
In case you care, I have no objections to the vaccine. I'm too young (36 and not working in care) to get it any time soon. But I'd take it tomorrow if it were available for me.
As far as I understand, the delivery systems were a large part of the research necessary to make RNA-based drugs possible. What the RNA does inside the cell we know reasonably well (I'm simplifying a lot here ), but getting the RNA into the cells efficiently was the original problem to be solved.
So I don't think those are really standard components, there are a lot of ways to create different systems here with different properties.
As a more general comment on this concern about additives, this is typically targeted at vaccines with adjuvants. Adjuvants are designed to create a stronger immune response, the lipids here are not adjuvants and as far as I understand the mRNA vaccines don't contain any adjuvants. I don't agree with the general concerns about adjuvants (though of course each vaccine has to prove safety in the studies on their own), but they are an additive with an inherently higher risk than something more inert. The immune system is extremely complex and highly dangerous.
So I don't think those are really standard components, there are a lot of ways to create different systems here with different properties.
As a more general comment on this concern about additives, this is typically targeted at vaccines with adjuvants. Adjuvants are designed to create a stronger immune response, the lipids here are not adjuvants and as far as I understand the mRNA vaccines don't contain any adjuvants. I don't agree with the general concerns about adjuvants (though of course each vaccine has to prove safety in the studies on their own), but they are an additive with an inherently higher risk than something more inert. The immune system is extremely complex and highly dangerous.
No, the major difference in the Pfizer and Moderna vaccines are in the makeup of the lipid nanoparticle. Here's an article from Moderna last year on biodegradability of the LNPs they've developed. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383180/
Thanks for this article. I can see both vaccines consider the use of PEG to be important. Still looking for the other lipid ingredients in the Moderna vaccine.
You need to be looking at the lipid ingredients that the mRNA is delivered in. Polyethylene glycol causes allergic and other reactions. The 1,2 Distearoyl... is associated with immune suppression due to destruction of lymphocyte membranes within 8 hrs of administration. Still researching the 4-hydroxybutyl....
Why is this comment getting downvoted? seems like a fair question. I've seen this now in several threads where even questioning side effects of the vaccine gets downvoted and looked down upon like they did something illegal. This is not HN I used to know.
There's a tendency to highlight risks and sideeffects of this vaccine that is without any basis.
It's reasonable to ask what the risks are, but unspecific ramblings about risks aren't helpful and it's unreasonable to highlight very hypothetical risks compared to the very real risks of getting Covid-19.
Right now the risk issue seems pretty clearcut: There were no serious sideeffects in the trials. What gave me additional confidence is hearing in an interview with Paul Offit (one of the world's leading vaccine expers) that almost all serious vaccine sideeffects that appeared in the past with other vaccines would appear relatively quickly (within weeks). Thus if there would be common sideeffects we would know by now.
Thus we can with reasonable confidence say that if there are any serious sideeffects from the promising Covid-19 vaccines then in all likelyhood they will be rare. It seems almost impossible that the vaccines pose a greater risk than the risk of not using them.
It's reasonable to ask what the risks are, but unspecific ramblings about risks aren't helpful and it's unreasonable to highlight very hypothetical risks compared to the very real risks of getting Covid-19.
Right now the risk issue seems pretty clearcut: There were no serious sideeffects in the trials. What gave me additional confidence is hearing in an interview with Paul Offit (one of the world's leading vaccine expers) that almost all serious vaccine sideeffects that appeared in the past with other vaccines would appear relatively quickly (within weeks). Thus if there would be common sideeffects we would know by now.
Thus we can with reasonable confidence say that if there are any serious sideeffects from the promising Covid-19 vaccines then in all likelyhood they will be rare. It seems almost impossible that the vaccines pose a greater risk than the risk of not using them.
This is a great reply, and is a good reason why down-voting the original question is counter-productive: if it gets down-voted too much, fewer people will see the informative replies!
If the OP were spreading unsubstantiated panic then I would take a different view of it, but to me it appears as an honest concern about a novel medical procedure.
If the OP were spreading unsubstantiated panic then I would take a different view of it, but to me it appears as an honest concern about a novel medical procedure.
> It's reasonable to ask what the risks are, but unspecific ramblings about risks aren't helpful and it's unreasonable to highlight very hypothetical risks compared to the very real risks of getting Covid-19.
Where was this ramblings on OP's comment? He genuinly asked a question without mentioning any side effects. Why is it being downvoted?
Where was this ramblings on OP's comment? He genuinly asked a question without mentioning any side effects. Why is it being downvoted?
It's being downvoted because the commenter made no effort to show what kind of research they had done in order to relieve their worry. If they genuinely were "really really concerned" about the potential side effects then they would have done some research on what those effects could be, what scientists had done to account for them etc. If they have done no research, that is lazy, hence worthy of a downvote. If they have done research but not specified so then it is deceptive and worthy of a downvote.
This is getting worse than Stack Overflow.
So you can't ask a question for more clarification unless you spend hours researching the subject?. I can get that if it's a coding question and someone was looking for a solution. But this is a scientific subject and there is a pool of knowledgeable HN users who can help with this kind of questions.
So you can't ask a question for more clarification unless you spend hours researching the subject?. I can get that if it's a coding question and someone was looking for a solution. But this is a scientific subject and there is a pool of knowledgeable HN users who can help with this kind of questions.
I am not saying that simple questions deserve a downvote. However I do think that questions that are not asked in good faith should be. In this case, the person appeared to either be exaggerating their level of concern, or deliberately trying to cast doubt on the scientific process in an effort to sow distrust.
If they had simply removed the "really really" from the question I don't believe it would have been perceived in the way I gave above. You are trying to claim that this was a perfectly innocent question which it may well have been but you should also be aware how it might be interpreted differently. You have not mentioned how you believe bad faith questions should be treated on HN but I would guess you would agree that some of them would be deserving of downvotes.
If they had simply removed the "really really" from the question I don't believe it would have been perceived in the way I gave above. You are trying to claim that this was a perfectly innocent question which it may well have been but you should also be aware how it might be interpreted differently. You have not mentioned how you believe bad faith questions should be treated on HN but I would guess you would agree that some of them would be deserving of downvotes.
It shouldn’t be like that. Simple questions are completely acceptable on HN.
I totally agree. If you interpreted the question as "simple" that's fine. All I did was try to explain how it might be interpreted as a question that was asked in bad faith (i.e. with some relevant information deliberately omitted).
> It seems almost impossible that the vaccines pose a greater risk than the risk of not using them.
How about to a baby, or an unborn baby? The relative risk is almost certainly higher to a baby, but how high? We don't know, since there haven't been any longitudinal studies (for starters.) Which is why it would be unethical outside a clinical trial to administer it to younger people en masse.
Eventually the relative risk will be quantifiable, but it will take years. It took ~4 years for the increased risk of narcolepsy in children due to the H1N1 vaccine (Pandemrix) to be reported, for example.
How about to a baby, or an unborn baby? The relative risk is almost certainly higher to a baby, but how high? We don't know, since there haven't been any longitudinal studies (for starters.) Which is why it would be unethical outside a clinical trial to administer it to younger people en masse.
Eventually the relative risk will be quantifiable, but it will take years. It took ~4 years for the increased risk of narcolepsy in children due to the H1N1 vaccine (Pandemrix) to be reported, for example.
It was less than a year before people started reporting it, and it took less than 2 years before a study was released by the Swedish health agency warning of increased narcolepsy risk in Children--not 4.
Also the increased rate of narcolepsy was 0.005%. That's why it took several months before anyone noticed it.
Additionally the flu itself can cause the same kind of narcolepsy, which means that this vaccine was worse than other vaccines, but still potentially better than no vaccine at all.
Also the increased rate of narcolepsy was 0.005%. That's why it took several months before anyone noticed it.
Additionally the flu itself can cause the same kind of narcolepsy, which means that this vaccine was worse than other vaccines, but still potentially better than no vaccine at all.
> but still potentially better than no vaccine at all.
There's no 'potentially' to consider, the Swedish Medical Products Agency reported the relative risk in 2011:
... The relative risk of narcolepsy was four times higher in vaccinated children and adolescents (born from 1990) compared to unvaccinated individuals.
So, incorrect, when considering the relative risk, which is all people should be interested in. Catching bird flu/covid isn't inevitable for most people, far from it in fact.
There's no 'potentially' to consider, the Swedish Medical Products Agency reported the relative risk in 2011:
... The relative risk of narcolepsy was four times higher in vaccinated children and adolescents (born from 1990) compared to unvaccinated individuals.
So, incorrect, when considering the relative risk, which is all people should be interested in. Catching bird flu/covid isn't inevitable for most people, far from it in fact.
The study didn't control for the differences in the vaccinated and unvaccinated groups. Children with chronic medical conditions are more likely to be vaccinated, and some preliminary reports show a correlation between medical conditions that indicate flu vaccination and narcolepsy [1]. And from what I can tell, the control group didn't exclude kids vaccinated with other H1N1 vaccines.
Because of that, that study can't say that the 4x higher number is the relative risk of taking Pandermrix.
There are also issues with potential over diagnosis and recall bias because of public awareness of the issue through the media [1].
The real problem is that this effect is so small, not that the effect takes years to develop. We're talking 4 cases of narcolepsy per 100k kids. Even a 10 year long study of 30k Phase 3 vaccine participants is unlikely to discover something like that.
Nearly all new drugs that are released could have similar side effects. It's just not feasible to conduct studies large enough to discover them until you start rolling it out to millions of people.
1.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962758/
Because of that, that study can't say that the 4x higher number is the relative risk of taking Pandermrix.
There are also issues with potential over diagnosis and recall bias because of public awareness of the issue through the media [1].
The real problem is that this effect is so small, not that the effect takes years to develop. We're talking 4 cases of narcolepsy per 100k kids. Even a 10 year long study of 30k Phase 3 vaccine participants is unlikely to discover something like that.
Nearly all new drugs that are released could have similar side effects. It's just not feasible to conduct studies large enough to discover them until you start rolling it out to millions of people.
1.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962758/
The UK government has already stated that pregnant women won't be getting the vaccine. (https://inews.co.uk/news/health/covid-vaccine-pregnant-women...)
This seems at odds with the gung-ho "it's 100% safe" rhetoric of our politicians.
I am by no means an anti-vaxxer, but I'm already finding it creepy the way any concerns are simply being dismissed. It's also just bad policy: it means that any unexpected side-effects that do emerge (even if very rare / not serious) will look much worse and immediately stink of a cover-up.
What's wrong with saying: "We are confident, to a reasonable degree of certainty, that the risk of taking this vaccine is lower than the risk of contracting Covid"? Not "This vaccine is definitely safe". I am sick of politicians treating the electorate as if they are morons who can't understand the slightest bit of nuance.
As you mention, vaccines can cause harm and have done in the past. Some degree of caution might be warranted.
This seems at odds with the gung-ho "it's 100% safe" rhetoric of our politicians.
I am by no means an anti-vaxxer, but I'm already finding it creepy the way any concerns are simply being dismissed. It's also just bad policy: it means that any unexpected side-effects that do emerge (even if very rare / not serious) will look much worse and immediately stink of a cover-up.
What's wrong with saying: "We are confident, to a reasonable degree of certainty, that the risk of taking this vaccine is lower than the risk of contracting Covid"? Not "This vaccine is definitely safe". I am sick of politicians treating the electorate as if they are morons who can't understand the slightest bit of nuance.
As you mention, vaccines can cause harm and have done in the past. Some degree of caution might be warranted.
I've yet to hear anyone say "it's 100% safe". Any sources?
I mean really it's one of those things like driving to the shops that is pretty safe but not 100% and I think most people can figure that.
I mean really it's one of those things like driving to the shops that is pretty safe but not 100% and I think most people can figure that.
The concerns are not being "simply dismissed". You just didn't take the time to read any of the material.
"JCVI recognises that the MHRA’s advice is based on the absence of evidence in pregnancy, and not on the presence of evidence to implicate toxicity in pregnancy."
It's all laid out for anyone with true concerns. Here you go: https://assets.publishing.service.gov.uk/government/uploads/...
"JCVI recognises that the MHRA’s advice is based on the absence of evidence in pregnancy, and not on the presence of evidence to implicate toxicity in pregnancy."
It's all laid out for anyone with true concerns. Here you go: https://assets.publishing.service.gov.uk/government/uploads/...
Thanks for that. And you're right, I hadn't seen that document before.
But concerns absolutely are being dismissed. I've personally listened to Matt Hancock and other ministers doing it.
The idea that someone might want to wait just a little longer to see if any side effects emerge is not necessarily irrational.
Would you not concede that, if and when any unexpected side-effects do emerge (however rare or insignificant), this gung-ho attitude will backfire?
But concerns absolutely are being dismissed. I've personally listened to Matt Hancock and other ministers doing it.
The idea that someone might want to wait just a little longer to see if any side effects emerge is not necessarily irrational.
Would you not concede that, if and when any unexpected side-effects do emerge (however rare or insignificant), this gung-ho attitude will backfire?
> The idea that someone might want to wait just a little longer to see if any side effects emerge is not necessarily irrational.
In general, yes it is irrational. There is evidence that the benefits of vaccines (including this one) far outweigh the risks of side effects.
> Would you not concede that, if and when any unexpected side-effects do emerge (however rare or insignificant), this gung-ho attitude will backfire?
Sorry, but no, this is wildly irrational. Why are rare and insignificant side effects concerning when the lives of more than 60,000 people in the UK have already ended due to this virus?
In general, yes it is irrational. There is evidence that the benefits of vaccines (including this one) far outweigh the risks of side effects.
> Would you not concede that, if and when any unexpected side-effects do emerge (however rare or insignificant), this gung-ho attitude will backfire?
Sorry, but no, this is wildly irrational. Why are rare and insignificant side effects concerning when the lives of more than 60,000 people in the UK have already ended due to this virus?
"60,000 people in the UK have already ended due to this virus" how accurate is this? I do not know about the UK but here (Greece) they asked family members to sign that their relative died from covid when dying from something unrelated otherwise they are not allowed to retrieve the body for weeks. They also count 80-90 year olds that died as covid victims.
> they asked family members to sign that their relative died from covid when dying from something unrelated otherwise they are not allowed to retrieve the body for weeks.
At least in the UK and US this is misinformation and false. Cause of death is certified by doctors or coroners and added to a database that reported COVID deaths are pulled from. Family members do not have to sign anything before cause of death is determined. I'd wager that Greece is no different.
COVID deaths are well known. There are many scholarly articles out there on how they are counted for people who don't get their information from Facebook. Here's a quick little article for example. https://www.scientificamerican.com/article/how-covid-19-deat...
At least in the UK and US this is misinformation and false. Cause of death is certified by doctors or coroners and added to a database that reported COVID deaths are pulled from. Family members do not have to sign anything before cause of death is determined. I'd wager that Greece is no different.
COVID deaths are well known. There are many scholarly articles out there on how they are counted for people who don't get their information from Facebook. Here's a quick little article for example. https://www.scientificamerican.com/article/how-covid-19-deat...
I would certainly expect that to be the case in a sane system. Sadly I have seen too many bureaucratic insanities around so it does not seem far-fetched to me.
"and added to a database that reported COVID deaths are pulled from." database or excel spreadsheet? https://news.ycombinator.com/item?id=24689247
I don't use facebook, my sources are my aunt (my uncle died 5 days ago due to falling and hitting his head, combined with a stroke history) and a family friend who is a doctor (and claims to be aware of 11 of such cases), note that said doctor and my aunt do not know each other.
"and added to a database that reported COVID deaths are pulled from." database or excel spreadsheet? https://news.ycombinator.com/item?id=24689247
I don't use facebook, my sources are my aunt (my uncle died 5 days ago due to falling and hitting his head, combined with a stroke history) and a family friend who is a doctor (and claims to be aware of 11 of such cases), note that said doctor and my aunt do not know each other.
I have no idea what goes on in Greece or what incentive people would have to do that. But excess death numbers are higher than COVID deaths everywhere, so the numbers aren't likely that far off.
Also my fiancee, an ER doctor, assures me that this isn't the case in the US.
Also my fiancee, an ER doctor, assures me that this isn't the case in the US.
> It seems almost impossible that the vaccines pose a greater risk than the risk of not using them.
While this is a reasonable conclusion from what we've read in the media, it's worth noting that this is at odds with the official opinions of the EMA and the FDA.
They both believe more data is needed, or that the agencies need more time to analyze the data, before they can decree that the benefits most likely outweigh the risks. Otherwise, they'd have approved the vaccines already.
While this is a reasonable conclusion from what we've read in the media, it's worth noting that this is at odds with the official opinions of the EMA and the FDA.
They both believe more data is needed, or that the agencies need more time to analyze the data, before they can decree that the benefits most likely outweigh the risks. Otherwise, they'd have approved the vaccines already.
The FDA set a meeting date for December 10th, that was at least somewhat arbitrary. They reportedly had no one working for 4 days during Thanksgiving break, so It's likely they could have just worked through Thanksgiving and had that meeting last week if they'd wanted to.
AFAICR, they're required to put a minimum two week period between the emergency use authorization request and the meeting.
Yeah, the real reason the agencies haven't approved it is closer to "the wheels of bureaucracies that big turn very slowly", but the official reason is still that the data they've seen so far is inconclusive.
"the data they've seen so far is inconclusive" has connotations that I don't think the FDA has implied officially or unofficially.
There's also a strong political reason for the US to not approve the vaccine as fast.
Fauci had to walk back[0] comments about the UK "rushing" the approval, stating
"The point that I was really trying to make [...] in the United States there is such a considerable amount of tension of pushing back on the credibility of the safety and of the efficacy that if we in the United States had done it as quickly as the UK did [...] that if we had for example had approved it yesterday or tomorrow there would have been push-back on an already scrutinising society that has really in some respects in the United States too much scepticism about the process."
[0] https://www.bbc.co.uk/news/world-us-canada-55177948
Fauci had to walk back[0] comments about the UK "rushing" the approval, stating
"The point that I was really trying to make [...] in the United States there is such a considerable amount of tension of pushing back on the credibility of the safety and of the efficacy that if we in the United States had done it as quickly as the UK did [...] that if we had for example had approved it yesterday or tomorrow there would have been push-back on an already scrutinising society that has really in some respects in the United States too much scepticism about the process."
[0] https://www.bbc.co.uk/news/world-us-canada-55177948
> already scrutinising society that has really in some respects in the United States too much scepticism about the process
Such politeness :-))
Most people outside the US don't call what's happening in the US "scepticism" :-(
Such politeness :-))
Most people outside the US don't call what's happening in the US "scepticism" :-(
Neither do "most" in the US, technically. Lotta ignorant people nonetheless.
I'm just going to write it: There's always going to be a minority that's shafted by the medical community, we don't matter as long as the majority benefits (fair enough imo, except I can't do shit even if I sign up to absolve everyone of responsibility and take it all on myself).
There will be side effects, they will be dismissed by doctors, people will be marginalized, called uneducated morons and pushed towards more radical communities.
It won't stop until a critical mass of people realize this is no better than treating people differently for being gay.
Right now, the pharma/medical industries are all-powerful. Can't do anything significant without them involved, and if your doctors turn out to be idiots with a degree, well you're shit out of luck, especially in Europe, where the holy universal healthcare can not be questioned.
There will be side effects, they will be dismissed by doctors, people will be marginalized, called uneducated morons and pushed towards more radical communities.
It won't stop until a critical mass of people realize this is no better than treating people differently for being gay.
Right now, the pharma/medical industries are all-powerful. Can't do anything significant without them involved, and if your doctors turn out to be idiots with a degree, well you're shit out of luck, especially in Europe, where the holy universal healthcare can not be questioned.
This is a gross oversimplification and simply a dramatic response to a small problem.
Yes - pharma companys do make money from these vaccines. Yes - that creates a conflict of interest.
But Im not so sure what you expect will happen here? Of course there are side effects? Every medical treatment on earth - literally since humanity started - has had side effects. The question is if those side effects are justifiable in comparison to the prevented harm to society.
And if you ask me, the prospect of millions of dead people due to, or related to covid makes a pretty huge load of side-effects tolerable if you see it like that.
But Im not so sure what you expect will happen here? Of course there are side effects? Every medical treatment on earth - literally since humanity started - has had side effects. The question is if those side effects are justifiable in comparison to the prevented harm to society.
And if you ask me, the prospect of millions of dead people due to, or related to covid makes a pretty huge load of side-effects tolerable if you see it like that.
> There will be side effects
Everything in life has side effects. Everything in life has trade offs. It's not about the lack of side effects or even their magnitude or severity, it's about balance: do they help more than they harm?
The most innocent substance out there, water, can kill you. And I don't mean drowning.
https://en.m.wikipedia.org/wiki/Water_intoxication
Many of the arguments people make about modern medicine are:
A) uninformed
B) not made in good faith
Modern medicine is serving us quite well, so any counter argument better be rock solid.
I'd be curious what your specific complaint is and how you back it up.
Everything in life has side effects. Everything in life has trade offs. It's not about the lack of side effects or even their magnitude or severity, it's about balance: do they help more than they harm?
The most innocent substance out there, water, can kill you. And I don't mean drowning.
https://en.m.wikipedia.org/wiki/Water_intoxication
Many of the arguments people make about modern medicine are:
A) uninformed
B) not made in good faith
Modern medicine is serving us quite well, so any counter argument better be rock solid.
I'd be curious what your specific complaint is and how you back it up.
In the United States, "modern medicine" is sometimes a jobs project or wealth transfer scheme. Sometimes people are helped.
I found a neat link a year ago about how the medical system happily pays for fabulously-expensive interventions, but won't pay for things patients actually need: "Which Interventions Can Be Paid For: The Explanatory Power of 'Prasad’s Law'"- https://news.ycombinator.com/item?id=21728864
I found a neat link a year ago about how the medical system happily pays for fabulously-expensive interventions, but won't pay for things patients actually need: "Which Interventions Can Be Paid For: The Explanatory Power of 'Prasad’s Law'"- https://news.ycombinator.com/item?id=21728864
The grand parent post wasn't commenting about the US, it was commenting about Europe:
> Right now, the pharma/medical industries are all-powerful. Can't do anything significant without them involved, and if your doctors turn out to be idiots with a degree, well you're shit out of luck, especially in Europe, where the holy universal healthcare can not be questioned.
Where such abuses are rarer. The US healthcare system is broken, at least keep an eye on what other countries are doing. If say, Iceland, Germany, Italy, Japan start vaccinating, maybe it's time to get vaccinated ;-)
> Right now, the pharma/medical industries are all-powerful. Can't do anything significant without them involved, and if your doctors turn out to be idiots with a degree, well you're shit out of luck, especially in Europe, where the holy universal healthcare can not be questioned.
Where such abuses are rarer. The US healthcare system is broken, at least keep an eye on what other countries are doing. If say, Iceland, Germany, Italy, Japan start vaccinating, maybe it's time to get vaccinated ;-)
I'm hearing people asking "what if there are some horrible side-effects 10 years down the road?" which appears to be a reasonable concern.
However, we don't know the side-effects 10 years down the road for COVID-19. I, for one, am far less concerned about potential vaccine side-effects than I am about known lung scarring and whatever potential side-effects could emerge from COVID-19.
However, we don't know the side-effects 10 years down the road for COVID-19. I, for one, am far less concerned about potential vaccine side-effects than I am about known lung scarring and whatever potential side-effects could emerge from COVID-19.
And the long term effects for 10+ year periods can't really be evaluated.
Otherwise all modern life would screech to a halt. For example, please stop using all new tech products developed in the last 10 years. And all the things developed with new materials science in the last 10 years.
We'd be back to the stone age. For these cases we measure short term effects and we extrapolate based on similar materials, structures, etc.
Otherwise all modern life would screech to a halt. For example, please stop using all new tech products developed in the last 10 years. And all the things developed with new materials science in the last 10 years.
We'd be back to the stone age. For these cases we measure short term effects and we extrapolate based on similar materials, structures, etc.
Please elaborate about what you said regarding Europe. There are many radically different health systems in Europe. NHS can't be compared at all to the Greek health system for example.
I don't understand the downvotes either...
Today UK regulators have even warned people with history of allergies, so apparently my concerns were not unjustified: https://www.businessinsider.com/pfizer-vaccine-allergy-covid...
Today UK regulators have even warned people with history of allergies, so apparently my concerns were not unjustified: https://www.businessinsider.com/pfizer-vaccine-allergy-covid...
I find it hilarious that the HN audience with "science-backgrounds" are rushing to inject "first generation tech" into their bodies. I remember many people stated they would wait until the 3rd generation of VR headsets before purchasing one.
I guess some knowledge & intuitions don't generalize.
Reminds me of a tech-savvy Youtuber that stated "I'm teaching myself to trust Tesla autopilot and ignore my need to fearfully jump to the wheel every time FSD moves me too close to objects on the road", "I'm getting better at it"... implying that 100s of thousands of years of evolutionary development/intuition/skepticism can be discarded when 1st gen tech enters the room.
*Note: I don't see my comment when logged out, shadowbanned perhaps...I'm starting to understand what "the right" has been talking about free speech-wise...will the tech overlords grant me permission to share my view...? Time to pray.
I guess some knowledge & intuitions don't generalize.
Reminds me of a tech-savvy Youtuber that stated "I'm teaching myself to trust Tesla autopilot and ignore my need to fearfully jump to the wheel every time FSD moves me too close to objects on the road", "I'm getting better at it"... implying that 100s of thousands of years of evolutionary development/intuition/skepticism can be discarded when 1st gen tech enters the room.
*Note: I don't see my comment when logged out, shadowbanned perhaps...I'm starting to understand what "the right" has been talking about free speech-wise...will the tech overlords grant me permission to share my view...? Time to pray.
> I'm starting to understand what "the right" has been talking about free speech-wise...will the tech overlords grant me permission to share my view...?
You created a new account specifically for this comment. Is HN, in your eyes, allowed to gate the publication of your comment on passing some moderation queue within reasonable time?
You created a new account specifically for this comment. Is HN, in your eyes, allowed to gate the publication of your comment on passing some moderation queue within reasonable time?
Delaying buying a VR headset doesn't create a significant risk of death. Different situation.
There isn't any evidence for serious side-effects from mRNA vaccines. The vaccines have undergone significant testing, and they're not doing anything magical.
If you're going to insinuate that the vaccines have significant risks, you should provide some evidence. (This bar should also be a bit higher in my opinion in the middle of a public health emergency.)
Compare a statement like "5g has great potential, but I'm really, really concerned about the health risks of 5g towers". I'd expect that to get voted down too unless you had some remarkable evidence.
If you're going to insinuate that the vaccines have significant risks, you should provide some evidence. (This bar should also be a bit higher in my opinion in the middle of a public health emergency.)
Compare a statement like "5g has great potential, but I'm really, really concerned about the health risks of 5g towers". I'd expect that to get voted down too unless you had some remarkable evidence.
I think a lot of people here, me included, are well aware that despite your best intentions and best understanding and application of testing, things can go drastically wrong at or after launch of a new anything. Eventually we learn what the issue is and make sure it doesn't happen again. But if you look at all the tests we have in place, you have to remember that a significant number of them came from discovering stuff in the field rather than before the launch.
This applies to everything from building bridges (University of Miami), through software products (Mars Climate Orbiter) to designing new medicines (thalidomide / paroxetine).
Arrogance that something is 100% safe is only ignorance. The point is we'd like to understand what the known risks are and the mechanisms are. Some of us would like to see a few hundred-thousand cars go over that new wobbly cantilever bridge design.
This is different from complete ignorance and denial which is a separate issue.
This applies to everything from building bridges (University of Miami), through software products (Mars Climate Orbiter) to designing new medicines (thalidomide / paroxetine).
Arrogance that something is 100% safe is only ignorance. The point is we'd like to understand what the known risks are and the mechanisms are. Some of us would like to see a few hundred-thousand cars go over that new wobbly cantilever bridge design.
This is different from complete ignorance and denial which is a separate issue.
> his applies to everything from building bridges (University of Miami), through software products (Mars Climate Orbiter) to designing new medicines (thalidomide / paroxetine).
It probably says something that neither of the ‘new medicines’ you cite (neither of which are or were vaccines) are >30 years old. Thalidomide was banned before most people on here were born.
There’s reason for scepticism in all things - but scepticism for its own sake, and without any evidence other than association is probably less than helpful.
It probably says something that neither of the ‘new medicines’ you cite (neither of which are or were vaccines) are >30 years old. Thalidomide was banned before most people on here were born.
There’s reason for scepticism in all things - but scepticism for its own sake, and without any evidence other than association is probably less than helpful.
> Some of us would like to see a few hundred-thousand cars go over that new wobbly cantilever bridge design.
It's extremely rare for bridges to fail. I certainly wouldn't expect a bridge to fail given modern safety standards.
You might have marginally more confidence in the bridge after a few hundred thousand cars, but we have processes in place to be confident within reasonable doubt that things are safe before that.
No one is claiming that anything is "100% safe". That's an unachievable level of confidence. If everyone waited for a hundred thousand other people to do anything we'd never get anywhere.
It's extremely rare for bridges to fail. I certainly wouldn't expect a bridge to fail given modern safety standards.
You might have marginally more confidence in the bridge after a few hundred thousand cars, but we have processes in place to be confident within reasonable doubt that things are safe before that.
No one is claiming that anything is "100% safe". That's an unachievable level of confidence. If everyone waited for a hundred thousand other people to do anything we'd never get anywhere.
What crazy logic is this? You are saying one needs to have evidence of risk in order to ask if there is any evidence of risk.
What is wrong with people when simply asking about negative impacts of a rushed vaccine is considered a worthless distraction.
I thought the audience of hacker news users would also be curious, inquisitive folk.
What is wrong with people when simply asking about negative impacts of a rushed vaccine is considered a worthless distraction.
I thought the audience of hacker news users would also be curious, inquisitive folk.
Yeah, I'm quite surprised too.
I've been lurking here for at least 10 years and consider this to be the best place to discuss everything openly. But this sensivity to question anything related to vaccine is beyond ridiculous. Even asking what the side effects are like OP did gets you downvoted.
And by the way, I will take the vaccine asap because of my health issues, but this doesn't mean we can't even ask questions about it.
I've been lurking here for at least 10 years and consider this to be the best place to discuss everything openly. But this sensivity to question anything related to vaccine is beyond ridiculous. Even asking what the side effects are like OP did gets you downvoted.
And by the way, I will take the vaccine asap because of my health issues, but this doesn't mean we can't even ask questions about it.
I have no objection to taking the vaccine but being as informed as you possibly can about your short and long-term health is surely important. After all this crisis is about health, we are clearly concerned with our health so why does this not extend to concern around a rapidly developed vaccine that you are going to put in your body?
Humans err all the time, why is this an exception? Why is no one here skeptical, or at least curious? Why is critical thinking set aside?
Science is now relative. Not only do we have mass misinformation but the side effect is an overreaction seeing intelligent thinkers reject their principles in order to put as much distance as possible between them and the perceived thought cancer.
What we are witnessing is compulsory hard-line. Where will you be when the mob comes after your curiosity? How many friends will you lose, how many thoughts of your own will you be free to have?
I really don't get how everyone is ok with ushering in what would otherwise be seen as dystopia. And don't compare this to a war. Wars are to preserve freedom and our principles. This war is the complete opposite. We have given up on free thinking, western values are out the window, right or wrong, but make no mistake this is the reality and we should at least acknowledge it as such.
Humans err all the time, why is this an exception? Why is no one here skeptical, or at least curious? Why is critical thinking set aside?
Science is now relative. Not only do we have mass misinformation but the side effect is an overreaction seeing intelligent thinkers reject their principles in order to put as much distance as possible between them and the perceived thought cancer.
What we are witnessing is compulsory hard-line. Where will you be when the mob comes after your curiosity? How many friends will you lose, how many thoughts of your own will you be free to have?
I really don't get how everyone is ok with ushering in what would otherwise be seen as dystopia. And don't compare this to a war. Wars are to preserve freedom and our principles. This war is the complete opposite. We have given up on free thinking, western values are out the window, right or wrong, but make no mistake this is the reality and we should at least acknowledge it as such.
The vaccines have undergone significant testing, and they're not doing anything magical.
"Significant testing" is 20,000 people. We're preparing to roll it out to billions. That's not "significant testing". If there was a 1 in 500,000 side effect, you'd never see it in the trials.
And yes, these vaccines are doing something "magical". We've never had an mRNA vaccine rolled out to the general public before.
That said, I think the risk is manageable. The FDA and EMA will be monitoring closely for side effects and is prepare to adjust as necessary.
But don't underestimate the risks.
"Significant testing" is 20,000 people. We're preparing to roll it out to billions. That's not "significant testing". If there was a 1 in 500,000 side effect, you'd never see it in the trials.
And yes, these vaccines are doing something "magical". We've never had an mRNA vaccine rolled out to the general public before.
That said, I think the risk is manageable. The FDA and EMA will be monitoring closely for side effects and is prepare to adjust as necessary.
But don't underestimate the risks.
> "Significant testing" is 20,000 people. We're preparing to roll it out to billions. That's not "significant testing". If there was a 1 in 500,000 side effect, you'd never see it in the trials.
That is significant testing. It is correct that you might not see a 1 in 500,000 side-effect in testing, but a 1 in 500,000 adverse effect is probably a risk factor that most people could accept.
> And yes, these vaccines are doing something "magical". We've never had an mRNA vaccine rolled out to the general public before.
Our cells regularly process strands of mRNA by the billion. I don't believe the vaccine is doing anything particularly "magical". It's completely right that we should test that, but I don't think there's any reason to be more concerned than any other new type of treatment.
That is significant testing. It is correct that you might not see a 1 in 500,000 side-effect in testing, but a 1 in 500,000 adverse effect is probably a risk factor that most people could accept.
> And yes, these vaccines are doing something "magical". We've never had an mRNA vaccine rolled out to the general public before.
Our cells regularly process strands of mRNA by the billion. I don't believe the vaccine is doing anything particularly "magical". It's completely right that we should test that, but I don't think there's any reason to be more concerned than any other new type of treatment.
Statins were tested in tens of thousands and the treated population is probably 100x to 1000x.
With the Covid vaccine we’re talking 10,000x expansion of patient population.
And your body also uses neurotransmitters all the time but we don’t wave our hands and say antidepressants are ok because they just modify neurotransmitters. New technology means new "unknown unknowns".
But with that said, I'm not saying don't get the vaccine. I'm just saying, don't be so confident that there is no risk.
With the Covid vaccine we’re talking 10,000x expansion of patient population.
And your body also uses neurotransmitters all the time but we don’t wave our hands and say antidepressants are ok because they just modify neurotransmitters. New technology means new "unknown unknowns".
But with that said, I'm not saying don't get the vaccine. I'm just saying, don't be so confident that there is no risk.
This whole pandemic has fued with our critical thinking. If you rewound to 2019 and had a story about a flu vaccine that had been rushed through we'd all be asking questions.
Just because there is a huge necessity to rush approval and dispersement doesn't mean the risks of unknown side effects are diminished. Lengthy approval processes and clinical trials are in place for a reason. And when you administer this vaccine to billions of people you are almost certain to see side effects. That's just simple science.
Just because there is a huge necessity to rush approval and dispersement doesn't mean the risks of unknown side effects are diminished. Lengthy approval processes and clinical trials are in place for a reason. And when you administer this vaccine to billions of people you are almost certain to see side effects. That's just simple science.
Risk of getting the vaccine has to be measured against risk of not getting the vaccine, which obviously seems much higher to me. You can’t just talk about risk in a vacuum.
There is a wealth of information available online about these vaccines. If someone comes along and says "I dunno, this thing that could end our civilization-altering event might be bad" is someone who has no real interest in the safety of the vaccine. If they did, they would not be trolling on HN, they would be reading and informing themselves.
> This is not HN I used to know.
Then you haven't been paying much attention. Using downvote as 'disagree' is and has been very much the norm around here.
Also, if one was here to push their antivaxxer propaganda (not saying they are), that's the kind of innocent question they'd start with, and yours with a fresh account (not saying you're a sockpuppet) would be the similarly innocent continuation.
Then you haven't been paying much attention. Using downvote as 'disagree' is and has been very much the norm around here.
Also, if one was here to push their antivaxxer propaganda (not saying they are), that's the kind of innocent question they'd start with, and yours with a fresh account (not saying you're a sockpuppet) would be the similarly innocent continuation.
I actually mentioned that I'm getting the vaccine further down the thread and I've been lurking here for years.
You are suspecting people and just adding "not saying". Which makes everything people say suspect.
You are suspecting people and just adding "not saying". Which makes everything people say suspect.
I see you're not taking my comment at face value, either =). I'm simply pointing out that particular familiar pattern that GP's opening and your defence to it so perfectly matches, whether it's intentional or by accident. On a topic that tends to draw in comments with weird agenda. Which is likely what the downvoters are reacting to.
https://www.youtube.com/watch?v=35Idb_lCU4o
by Ninja Nerd Lectures
This is the best science based informative video I have seen on how these different Covid vaccines actually work.
by Ninja Nerd Lectures
This is the best science based informative video I have seen on how these different Covid vaccines actually work.
> I feel like mRNA vaccines have huge potential, but I am really, really concerned about potential side effects.
Would you mind expanding on this? Why are you severely concerned about side effects for mRNA vaccines in particular?
Would you mind expanding on this? Why are you severely concerned about side effects for mRNA vaccines in particular?
Adjuvants in modern vaccines are extraordinarily well studied and safe. Current side effects include 6-24 hours of feeling totally crappy. Still beats Covid-19...
How modern is "modern" here? Because the whole Pandermix saga happened only a decade ago and some are pointing towards the combination of the adjuvant and antigen: https://www.bmj.com/content/362/bmj.k3948/rr-22
Considering that this doesn't seem to be a settled question, I'm not so sure that it makes sense to blindly trust that everything will be alright in the current, rushed, case.
Considering that this doesn't seem to be a settled question, I'm not so sure that it makes sense to blindly trust that everything will be alright in the current, rushed, case.
It's worth pointing out that the Pandemrix "saga" affected very few people.
According to [1], "The UK Health Protection Agency (now Public Health England) undertook a major study of 4- to 18-year-olds and found that around one in every 55,000 jabs led to narcolepsy."
Very rare frequency incidents that slip through testing shouldn't make us over-cautious to the enormous benefits of vaccination.
[1] https://www.narcolepsy.org.uk/resources/pandemrix-narcolepsy
According to [1], "The UK Health Protection Agency (now Public Health England) undertook a major study of 4- to 18-year-olds and found that around one in every 55,000 jabs led to narcolepsy."
Very rare frequency incidents that slip through testing shouldn't make us over-cautious to the enormous benefits of vaccination.
[1] https://www.narcolepsy.org.uk/resources/pandemrix-narcolepsy
The whole Pandermix risk is much smaller than the risks in the current pandemics. Narcolepsy is very rare disease and even increased risk due to that vaccine remains very low as absolute value and it only appears high if it's expressed as a relative number.
In establishing the shorter-term safety nothing was "rushed" now compared to the processes performed before (it was tested on tens of thousands of people). Regarding the longer-term safety, who would be willing to wait e.g. two more years before any vaccine could be used?
As the vaccination will be voluntary for common people, as long at there are shortages, those who don't want to get it should indeed leave it to those who will.
In establishing the shorter-term safety nothing was "rushed" now compared to the processes performed before (it was tested on tens of thousands of people). Regarding the longer-term safety, who would be willing to wait e.g. two more years before any vaccine could be used?
As the vaccination will be voluntary for common people, as long at there are shortages, those who don't want to get it should indeed leave it to those who will.
To elaborate the absolute numbers: around 1 in 55000 vaccinated were affected by the side effects in two years, so even if everybody in the UK was vaccinated with something causing such side effects, that translates to 1200 with the side effects.
To compare, there were more than 70,000 excess deaths in the UK since start of pandemics. Around 60 times more deaths than, in the case of vaccine, those still living with side effects.
But these side effects were apparently the strongest in just a part of the population: 4-18, which is 11 million, resulting is estimated 200 people with side effects.
Covid-19 luckily affects exactly that part of population less, but even then I'd guess that Covid-19 already made more damage to more than 200 people in it.
And that small number of cases just can't be detected unless the trial covers enough of those affected. If the total effect is 200 cases in the whole population, a trial would have to be performed on at least one 20th of it: as much as 600,000 children would have to be a part of the trial to even detect that issue. Not to mention that it took two years to recognize the issue.
Now, for the trial to recognize the problem, half would have to be placebo group. That gives once all outside of the trial are counted 97.5% of people unprotected for two years.
In the case of whole population, and even waiting for only 10 months, there would still be 68,000 deaths more if that kind of trial would be a condition for the acceptance of vaccine.
To compare, there were more than 70,000 excess deaths in the UK since start of pandemics. Around 60 times more deaths than, in the case of vaccine, those still living with side effects.
But these side effects were apparently the strongest in just a part of the population: 4-18, which is 11 million, resulting is estimated 200 people with side effects.
Covid-19 luckily affects exactly that part of population less, but even then I'd guess that Covid-19 already made more damage to more than 200 people in it.
And that small number of cases just can't be detected unless the trial covers enough of those affected. If the total effect is 200 cases in the whole population, a trial would have to be performed on at least one 20th of it: as much as 600,000 children would have to be a part of the trial to even detect that issue. Not to mention that it took two years to recognize the issue.
Now, for the trial to recognize the problem, half would have to be placebo group. That gives once all outside of the trial are counted 97.5% of people unprotected for two years.
In the case of whole population, and even waiting for only 10 months, there would still be 68,000 deaths more if that kind of trial would be a condition for the acceptance of vaccine.
But the Pfizer and Moderna vaccines have no "adjuvants". What are you getting at?
They don't have adjuvants, but they do have lipid nanoparticles which allow the mRNA to breach cells. It's feasible that they could cause unexpected side effects.
NB: I'm personally going to get the first SARS-CoV-2 vaccine I can get, and I'm incredibly excited about mRNA vaccines in general. But, it's true that any time you inject a chemical into your bloodstream you're taking a calculated risk.
NB: I'm personally going to get the first SARS-CoV-2 vaccine I can get, and I'm incredibly excited about mRNA vaccines in general. But, it's true that any time you inject a chemical into your bloodstream you're taking a calculated risk.
Please name a vaccine that is injected into your bloodstream.
It's good to see that HN continues to find ways to increase pedantry! You know what I meant, intramuscularly.
“You know what I meant”
No. I am not a mindreader. And “vaccines are injected into the bloodstream” is a standard antivax lie.
Yes there’s a risk in receiving a vaccine, just as there’s a risk in receiving any prophylactic/therapeutic treatment, but severe side-effects are closer to 1-in-100K to 1-in-a-million. Compared to a disease that is currently killing 2-in-100, with significant sequelae likely much higher.
I’m happy to accept that “bloodstream” was a slip of the tongue, but really try not to make those malignant lying bastards’ jobs any easier, when people die because of them.
No. I am not a mindreader. And “vaccines are injected into the bloodstream” is a standard antivax lie.
Yes there’s a risk in receiving a vaccine, just as there’s a risk in receiving any prophylactic/therapeutic treatment, but severe side-effects are closer to 1-in-100K to 1-in-a-million. Compared to a disease that is currently killing 2-in-100, with significant sequelae likely much higher.
I’m happy to accept that “bloodstream” was a slip of the tongue, but really try not to make those malignant lying bastards’ jobs any easier, when people die because of them.
If you had actually read what I wrote thoughtfully -- instead of falling over yourself to type a glib reply as fast as you could get it out -- it would have been easy to recognize that I am clearly not anti-vaccine, nor was I suggesting that side effects are common. I said both of those things explicitly.
If your goal is actually to educate others, then educate others. Replying with snark achieves nothing but temporarily boosting your own ego.
If your goal is actually to educate others, then educate others. Replying with snark achieves nothing but temporarily boosting your own ego.
Yes I read your post, and yes it was poorly worded. Take the tip and move on.
FTR, FDA has approved a product (not a mRNA vaccine) using lipid nanoparticles in 2018.
mRNA vaccines had also (limited) human testing before these trials in the past years (mostly Phase 1).
mRNA vaccines had also (limited) human testing before these trials in the past years (mostly Phase 1).
I know. I don't see how it refutes what I said. I'm not anti-vaccine, I was just replying to the parent comment suggesting that because these mRNA vaccines don't use adjuvants they wouldn't have side effects.
All medicines represent calculated risks -- risks that are often worth taking, but still risks.
All medicines represent calculated risks -- risks that are often worth taking, but still risks.
> First person receives Pfizer Covid-19 vaccine in UK
*after getting approval from regulators
Tens of thousands already received the vaccine during trials. This marks the official rollout with general public availability (pending supply issues), so that's cool. It's just weird that the article refers to this dose in particular as a "historic event".
*after getting approval from regulators
Tens of thousands already received the vaccine during trials. This marks the official rollout with general public availability (pending supply issues), so that's cool. It's just weird that the article refers to this dose in particular as a "historic event".
Literally first line of the article:
> A UK grandmother has become the first person in the world to be given the Pfizer Covid-19 jab as part of a mass vaccination programme.
> A UK grandmother has become the first person in the world to be given the Pfizer Covid-19 jab as part of a mass vaccination programme.
Yes, I read it.
Literally the second line of my comment:
> This marks the official rollout with general public availability (pending supply issues), so that's cool. It's just weird that the article refers to this dose in particular as a "historic event".
Here's the line from the article I'm referring to:
> Prof Stephen Powis, national medical director of NHS England, who witnessed the "historic moment", said: "We couldn't hug her but we could clap and everybody did so in the room."
They even quoted "historic moment" almost like they were being sarcastic about it. It's just weird.
Literally the second line of my comment:
> This marks the official rollout with general public availability (pending supply issues), so that's cool. It's just weird that the article refers to this dose in particular as a "historic event".
Here's the line from the article I'm referring to:
> Prof Stephen Powis, national medical director of NHS England, who witnessed the "historic moment", said: "We couldn't hug her but we could clap and everybody did so in the room."
They even quoted "historic moment" almost like they were being sarcastic about it. It's just weird.
It's likely that "historic moment" is quoted as Powis said those particular words.
The vaccines would be a current and global talking point. It's natural that the first post-testing vaccines would be a significant moment, that someone involved would feel it was of historic note, and that a publication would use that phrasing to accentuate the story's weight.
It's the/a major story on every news site I checked this evening.
The vaccines would be a current and global talking point. It's natural that the first post-testing vaccines would be a significant moment, that someone involved would feel it was of historic note, and that a publication would use that phrasing to accentuate the story's weight.
It's the/a major story on every news site I checked this evening.
> It's likely that "historic moment" is quoted as Powls said those particular words.
That could be. Hopefully it's understandable that I didn't come to that conclusion because the article does not attribute those words to anyone.
> The vaccines would be a current and global talking point. It's natural that the first post-testing vaccines would be a significant moment, that someone involved would feel it was of historic note, and that a publication would use that phrasing to accentuate the story's weight.
Yeah, I suppose, but it's still weird to me. I don't care about the details of the first publicly administered dose. What really matters to me is that doses are now publicly available (kind of, depending on need for now).
Nothing about the "first" dose strikes me as being of historical note other than the timestamp and the milestone it represents. But I guess that's a matter of opinion and a lot of people seem to disagree with me.
That could be. Hopefully it's understandable that I didn't come to that conclusion because the article does not attribute those words to anyone.
> The vaccines would be a current and global talking point. It's natural that the first post-testing vaccines would be a significant moment, that someone involved would feel it was of historic note, and that a publication would use that phrasing to accentuate the story's weight.
Yeah, I suppose, but it's still weird to me. I don't care about the details of the first publicly administered dose. What really matters to me is that doses are now publicly available (kind of, depending on need for now).
Nothing about the "first" dose strikes me as being of historical note other than the timestamp and the milestone it represents. But I guess that's a matter of opinion and a lot of people seem to disagree with me.
It's between quotes presumably because it is, you know, a quote. And the start of the first public vaccination campaign against COVID-19 legitimately seems like a historic moment. But we're just nitpicking language now.
Then who are they quoting?
Prof Stephen Powis - the guy mentioned in the same sentence.
You can see the convention continues in the very next paragraph:
"The second person vaccinated in Coventry was William Shakespeare, 81, from Warwickshire, who said he was "pleased" to be given the jab and hospital staff had been "wonderful"."
You can see the convention continues in the very next paragraph:
"The second person vaccinated in Coventry was William Shakespeare, 81, from Warwickshire, who said he was "pleased" to be given the jab and hospital staff had been "wonderful"."
It is historic as in when they write the history it'll go something like covid was first detected in Wuhan in Dec 19, a mass vaccination program started on 8th Dec 20 and ...
anything for attention am i rite?
Remember that in 6 other countries, 20,000 people have received this vaccine as part of the phase 3 trial.
https://www.pfizer.com/science/coronavirus/vaccine
https://www.pfizer.com/science/coronavirus/vaccine
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I live in India. I am already hearing companies offering planned month long vacation tours to UK/US where you could get yourself vaccinated with vaccines that aren't available in India.
That seems bizarre — you’re much more likely to be able to get it privately in India or Thailand or any other country that has good healthcare for the rich and few qualms about allowing people to buy in private stock. Much easier to pay $500 to a private clinic in Mumbai than fly to the West and hope that you can convince the state to provide it
The state will not provide it to non-residents. As soon as you arrive in the UK, immigration stamps "no recourse to public funds" in black all-caps into your passport as a friendly reminder.
In this specific instance, you're probably right that there will be paperwork.
However, in general, acute healthcare in free in the UK and does not even require ID. I don't know if that's how it's "meant" to be, but that's how it is; if you're on vacation in the UK and something bad happens, you can just turn up at the nearest hospital and it will get sorted out, no bill no fuss.
However, in general, acute healthcare in free in the UK and does not even require ID. I don't know if that's how it's "meant" to be, but that's how it is; if you're on vacation in the UK and something bad happens, you can just turn up at the nearest hospital and it will get sorted out, no bill no fuss.
Foreign nationals without a visa (and non-resident British people, like me now) do receive a bill. I used to work in the department that recovers the money.
The rates are in an excel file linked on this page. Visitors pay 150% of the published rate. https://improvement.nhs.uk/resources/national-tariff/
The rates are in an excel file linked on this page. Visitors pay 150% of the published rate. https://improvement.nhs.uk/resources/national-tariff/
Out of curiosity, what kind of money we are talking about? For example checking up sprained ankle at A&E?
Many of my friends being disappointed with NHS go for example to Mexico for private treatment and it works much better that doing it here, plus you can enjoy the climate and great food.
Not giving medical advice but you probably shouldn't be going to A&E for a sprained ankle unless it's very serious or a suspected break.
For people who are not ordinarily resident in the UK an A&E admission costs £100-£500 plus any tests and treatment. There's a small amount of margin which is used to offset the cost of recovering the money and the fact that sometimes the bills go unpaid.
For people who are not ordinarily resident in the UK an A&E admission costs £100-£500 plus any tests and treatment. There's a small amount of margin which is used to offset the cost of recovering the money and the fact that sometimes the bills go unpaid.
I see, so it is not the kind of situation when you need to consider getting mortgage to pay off the medical bill.
It was just an example. General advice I heard is that when you can't go to GP and walk-in is either too far away or closed, you can go to A&E or call 111 for instructions.
It's not like the US system where people have to choose whether or not to call an ambulance but it's obviously better for visitors to come with health insurance since a policy covering most emergency healthcare, and various other eventualities that could happen on a trip, is probably around US$10-20 pp.
Yeah most of the NHS hospitals I know have "Minor Injury Units" - I generally think that if you can make your own way there they it probably isn't one for A&E.
Mind you the last time I went for something I thought wasn't very serious (a cat bite) I was told to go to A&E pretty quickly!
Mind you the last time I went for something I thought wasn't very serious (a cat bite) I was told to go to A&E pretty quickly!
How it’s “meant” to be is that you’re asked for where you’re registered, and your NHS records are pulled up, and if you’re not registered at a GP practice or in the NHS system you get a bill
That's not the case. There's no such thing as a single NHS records system. There's 4 separate NHS systems for each constituent country of the UK. If you go to A&E they cannot generally see your GP records - if they can, it's usually limited so for e.g. if you live in the same local NHS trust as the hospital is in.
That's not what happens, though. You can just say "I'm not registered with a GP" (and many people aren't), and you will still be treated - no bill.
If you aren't registered with a GP and have no records at the hospital there are other ways to check, for instance your National Insurance records. It's not easy to get away without paying if you are an ineligible person.
But I think there are some exceptions for communicable diseases, which they will treat without attempting to bill you. I doubt vaccination would fall under that but don't really know.
I think doctors have to ask for ID if they suspect someone is not eligible for free treatment. I know this happened for two of my friends and they had to show ID at A&E, but that was during the heat of Brexit campaign, so this could make doctors feel encouraged to do such checks. I have not heard about it for a long time now though.
There's not even any plans to offer vaccines privately in the UK yet. The NHS isn't going to offer it to travellers.
Not NHS, but what’s stopping private companies from purchasing from pfizer at 10x markup and selling to willing customers?
Doubt Pfizer has much spare stock just sitting around at this point, and also I’m guessing you’d need an import license for it. But I’d imagine once there’s plenty to go around you’ll absolutely start to see private offerings.
Some time in the future - maybe nothing. Right now - all current and future doses for many months (if not years) are accounted for in existing contracts. Selling the doses to private parties, especially at 10x markup would be a huge PR disaster and invitation to AGs to open investigations.
They could theoretically try to order it I suppose, but they're going to be at the end of a very long backlog.
Do we actually know all the details of who they’ve contracted with? I wouldn’t be surprised if
private healthcare providers in the UK already got their place in line.
I'd be somewhat surprised. In Ireland this year the _flu_ vaccine wasn't generally available privately, as the HSE took all available supply. Health authorities should be expected to be even more aggressive with covid vaccines.
I don't think private parties will have any access to vaccine for a while.
Can you imagine the shit storm if some wealth person got vaccinated ahead of the doctors treating dying Covid patients. Ain't gonna happen.
Can you imagine the shit storm if some wealth person got vaccinated ahead of the doctors treating dying Covid patients. Ain't gonna happen.
I've already heard stories about people in both China and Russia using bribes/connections to get themselves or relatives into vaccine trials. In particular, the Chinese military has been vaccinating its own since June.
https://www.cbc.ca/news/health/covid-vaccine-approved-milita...
https://www.cbc.ca/news/health/covid-vaccine-approved-milita...
Not really bribes, just go to the Taihe Hospital in Beijing and pay to be vaccinated. The Chinese are more laid back about regulating stuff. https://time.com/5902646/china-covid-19-vaccine/
> Can you imagine the shit storm if some wealthy person got vaccinated ahead of the doctors
In an ideal world, I suppose not. But, in the real world, I think I can. Yes.
In an ideal world, I suppose not. But, in the real world, I think I can. Yes.
It sounds like in some countries, the rich will be able to get the vaccine ahead of official channels - eg. https://www.cyclingweekly.com/news/racing/uae-team-emirates-...
On the contrary, vaccinations started early in November in the UAE. They are using the weaker Chinese vaccine though.
This kind of egregious injustice happens daily.
This will, too.
This will, too.
Well celebrities were tested before frontline workers.
The production so far has been funded through government contracts.
Pfizer's production is ordered for months out.
I would be gobsmacked if it isn’t available privately. I’m sure someone is planning it.
I’d guess that wide spread availability privately will coincide with when the highest risk groups have been vaccinated and then the government will say it’s “only right and proper” that people who aren’t very much at risk, who “can pay, should pay” rather than “burdening” the NHS and timed that they won’t look too callous.
I’d guess that wide spread availability privately will coincide with when the highest risk groups have been vaccinated and then the government will say it’s “only right and proper” that people who aren’t very much at risk, who “can pay, should pay” rather than “burdening” the NHS and timed that they won’t look too callous.
Why would they do that? If they are providing it free to those at high risk, why not provide it free to those at low risk? Why would they charge for this particular treatment when all other treatments are free? How could they ensure those who are poor and cannot afford to pay still get vaccinated?
The vaccine is not available privately in the UK. If you're not registered with the NHS, you're probably not going to be able to get vaccinated in the UK anytime soon. Even if you are registered, you will probably have to wait til late spring if you're under 50 with no underlying health issues.
This.
The idea that people are planning 'vaccine holidays' is bizarre.
The idea that people are planning 'vaccine holidays' is bizarre.
I'm sure people are planning one. That doesn't mean they will be successful. Most of the people with enough money to do this are alert for scams (though they might decide it is 80% chance of scam and decide to risk it anyway), so they will be looking to see if they will get the vaccine in the end, and if they don't think you will deliver they won't go.
I would expect anyone who gets a "black market" vaccine gets one of the not approved (yet) vaccines. That supply is sitting around and probably not tracked as much. Break into a warehouse (often with insider help, possibly at high levels such that most people in the company help you because your alibi checks out), get a supply, then send it to your black market buddies.
Pfizer has a legal market now and will do everything to ship to that market. Moderna is close enough that they won't risk it. The Oxford vaccine has a lot of companies who can make it and an uncertain future (60% effective when there is a 95%?) so it is the most likely candidate, for this. Russia also is making a vaccine that they might be willing to sell like this. China might as well, but I find it unlikely as they have other markets. Of course this whole paragraph is pure speculation: anything is possible.
The Pfizer vaccine won't be available privately in UK, not for a long time. So I think they will be disappointed.
What stops pfizer from selling directly to customers?
As someone who works in medical devices, there's huge sections of standards referring to confirming that software and devices reach the intended user untampered and analysing the risk of selling to an untrained customers and things like that.
The long and the short of it always boils down to, it's not worth the risk to sell to individuals. Because if something goes wrong and someone is injured or killed, the regulatory agencies are going to come down on you like a ton of bricks
I would assume similar practices exist for pharmaceuticals.
The long and the short of it always boils down to, it's not worth the risk to sell to individuals. Because if something goes wrong and someone is injured or killed, the regulatory agencies are going to come down on you like a ton of bricks
I would assume similar practices exist for pharmaceuticals.
Lack of supply. They’ve already pre-sold all they could make to governments.
Presumably they pre-sold based on estimates of their production. I would not be very surprised if it turns out they can make 10% more than they committed, and auction this off. And would expect hospitals treating Saudi princelings & the like to win such an auction.
But does anyone actually know what these pre-sale contracts look like? They must have some wiggle room in case production doesn't go as well as planned... are there just penalties for late delivery to specific customers, or explicitly tied to total production, or did they literally sell places in the queue, or what?
But does anyone actually know what these pre-sale contracts look like? They must have some wiggle room in case production doesn't go as well as planned... are there just penalties for late delivery to specific customers, or explicitly tied to total production, or did they literally sell places in the queue, or what?
Companies that have a vaccine are aware of image. They know that the world is watching, and this is a big marketing opportunity. They will make a profit, but long term goodwill is more valuable than any profit they could make selling to billionaires, so I doubt anything will go to auction.
The hospitals treating Saudi princes are real hospitals. So they can win auctions if it comes down to that, because they are invited to them while the rest of the black market isn't. I don't think real vaccines will come to auction though.
There is one thing left: vaccines that have approval issues. Any vaccine that is somewhat effective by not enough (The Oxford vaccine at 65% efficiency is questionable). The Russian vaccine. Any of many that haven't started phase 3 trails yet. Any vaccine that has safety issues. All are candidates for someone to "leak" to the underground. You will have to consider the risks, but it might be worth it to get it now and then in a year when the better vaccines come to you get that too.
The hospitals treating Saudi princes are real hospitals. So they can win auctions if it comes down to that, because they are invited to them while the rest of the black market isn't. I don't think real vaccines will come to auction though.
There is one thing left: vaccines that have approval issues. Any vaccine that is somewhat effective by not enough (The Oxford vaccine at 65% efficiency is questionable). The Russian vaccine. Any of many that haven't started phase 3 trails yet. Any vaccine that has safety issues. All are candidates for someone to "leak" to the underground. You will have to consider the risks, but it might be worth it to get it now and then in a year when the better vaccines come to you get that too.
Yes, an actual open auction would be astonishingly bad PR! But quietly, on the side? Maybe I'm a cynic but I struggle to believe the billionaires won't find a way.
If not from the main production... they had 43538 phase III participants, there must be leftovers, which won't appear in the books as real production... maybe you can route those to important donors of your philanthropic arm, or something? Run some "further trials" in a variety of small clinics, including those catering to visiting Saudis?
Plus actual black market stuff of course, I wonder if any of their refrigerated shipping boxes have gone missing? And, as you say, things like the Russian vaccine are probably already available at a price.
If not from the main production... they had 43538 phase III participants, there must be leftovers, which won't appear in the books as real production... maybe you can route those to important donors of your philanthropic arm, or something? Run some "further trials" in a variety of small clinics, including those catering to visiting Saudis?
Plus actual black market stuff of course, I wonder if any of their refrigerated shipping boxes have gone missing? And, as you say, things like the Russian vaccine are probably already available at a price.
The risk of being caught trying to pull that off as a company are too big. Though there might be some individual who does something against company policy, but it is hard to keep such things secret if they involve more than a couple people.
Last I'd heard, they overestimated how much they could produce and presold more than they could actually deliver at least at first.
Probably the billions that governments have paid for their place in the queue
India alone has 759k millionaires. Assuming each has a family of four, and they’re willing to pay just $500 for a two shot course on an exclusive basis (say). That alone will be make pfizer about 1.58 billion dollars.
There are 13555k millionaires outside of Europe and US. The 1.9 billion paid by the US government for 100million viles pales in front of what pfizer could earn by catering to the rich.
So, again, my question stands, why wouldn’t pfizer sell directly to customers? What binds them to just deal with governments alone? I ask this as a humble non-millionaire (just to clarify that I wouldn’t benefit from such a scheme in any way) :)
There are 13555k millionaires outside of Europe and US. The 1.9 billion paid by the US government for 100million viles pales in front of what pfizer could earn by catering to the rich.
So, again, my question stands, why wouldn’t pfizer sell directly to customers? What binds them to just deal with governments alone? I ask this as a humble non-millionaire (just to clarify that I wouldn’t benefit from such a scheme in any way) :)
Do you honestly think Pfizer would come off well (PR wise) if they put millionaires in the front of the queue for cash? At a time when vulnerable people are dying? The $1.58bn wouldn’t be worth sinking their entire brand, not even close.
Pfizer doesn't have to do anything. The vaccines will be sent all over the world, all destined for reputable hospitals where they're intended to be used for elderly transgender orphans with pre-existing conditions working in COVID ICUs. However, some shipments will mysteriously fall off the truck on the way there, and will resurface at private hospitals for the elite who can and will pay large quantities for them.
They are already sold out. There’s no spare. And yes they can sell to millionaire but states purchases millions of doses at a Time, not 5.
I'd be up for it, no doubt.
Hong Kong doesn't seem interested to vaccinate people before 2022ish.
https://www.scmp.com/news/hong-kong/health-environment/artic...
Hong Kong doesn't seem interested to vaccinate people before 2022ish.
https://www.scmp.com/news/hong-kong/health-environment/artic...
Is this not just cynical marketing?
Sure, there are likely to be plenty of vaccines one could get in the UK/US that aren't available easily in India or elsewhere. But you/they didn't say anything about the COVID one...
Sure, there are likely to be plenty of vaccines one could get in the UK/US that aren't available easily in India or elsewhere. But you/they didn't say anything about the COVID one...
not surprising. i am shocked people aren’t hawking fakes on the dark net yet.
I am sure my Junk email box is full with offers for private vaccination already
I just checked, and I didn't see any. The closest was an offer for KN95 masks. (Though this is GMail, which I think has started to just auto-delete a lot of the worst stuff. My spam folder now gets spams-per-day rather than kilospams-per-day.)
[deleted]
Good luck to the average person getting it in the USA before March.
Even with half the population refusing it because the anti-vax people might be even more crazy than the anti-maskers.
Which makes you wonder which country will have covid longest.
Even with half the population refusing it because the anti-vax people might be even more crazy than the anti-maskers.
Which makes you wonder which country will have covid longest.
Can someone explain why it’s not enough to just vaccinate people who want to get vaccinated? Doesn’t that cover everyone who wants to avoid covid19?
No vaccine is ever 100%, you will see that some vaccinated people do get sick. In addition you have people that can't be vaccinated, these are still at risk.
But if you vaccinated enough people, the successful vaccinated will act as a kind of firewall and hinder the sickness from effectively spreading.
But comments above state that the vaccine doesn't effect spread. If that's true, then vaccinating everyone would not address any of those points.
It hasn't been proven to affect spread (because that wasn't tested for). But it's generally assumed it does to at least a degree.
It's also much harder to test spread. You'd have to do repeated follow-up of all participants with frequent testing. When you have 40,000 participants, that's a significant concern. Trials like these are called "large, simple trials" since at that scale it's impractical to have a complicated study design at that scale. In addition to the pure expense, it's difficult to comply consistently with the protocol if it's complicated and you need to implement it at dozens or hundreds of sites. And recruiting people becomes harder and harder as you need additional follow-up, and attrition is higher (and likely biased: you're more likely to take your test if you think you might be sick).
So it's entirely reasonable to just study symptomatic cases in these trials.
So it's entirely reasonable to just study symptomatic cases in these trials.
Theoretically if we return to "life as normal" once the vaccine has been distributed to everyone who wants it, but a significant portion of high risk individuals do not get vaccinated, it could overwhelm our hospitals.
That said, I think the fears about many people refusing the vaccine are completely overblown. All of the folks who I've talked to who are concerned about the vaccine have expressed willingness to get it after it has been out for a few months without major side effects. They wont qualify to be first in line anyways, so they'll have to wait regardless.
That said, I think the fears about many people refusing the vaccine are completely overblown. All of the folks who I've talked to who are concerned about the vaccine have expressed willingness to get it after it has been out for a few months without major side effects. They wont qualify to be first in line anyways, so they'll have to wait regardless.
IIUC, you want to vaccinate everyone to get actual herd immunity as quickly as possible so the virus can't spread before it has mutated into different strains.
The more of the population unvaccinated, the larger population available for new strains to generate in, the higher probability of multiple strains.
It's not guaranteed the current vaccines inoculate against new strains, so you could be right back at square one next winter, with a new virulent strain.
The more of the population unvaccinated, the larger population available for new strains to generate in, the higher probability of multiple strains.
It's not guaranteed the current vaccines inoculate against new strains, so you could be right back at square one next winter, with a new virulent strain.
For the same reason everyone who buys a motor vehicle has to buy one with a catalytic converter. The actions of every individual affect society as a whole.
Because we can't be bothered to go after cruise ships?
https://news.ycombinator.com/item?id=19016428
Why is your reply framed as an exclusive "or" choice?
There's probably a good chunk of people who want neither covid nor the vaccine. Life's messy like that.
The US vaccination plan has vaccinating non-essential (read average) people starting at around May-June, so no way it happens in March.
Doctors, the elderly and other more at risk groups will get it before that.
Doctors, the elderly and other more at risk groups will get it before that.
The US vaccination plan is state by state. In many states people working in food service and grocery stores, people under 60 who are overweight, have high blood pressure, asthma etc... will be offered the vaccine in phase 2. It’s not just doctors and the elderly, it’s a huge chunk of the population.
And depending on how many people actually want the vaccine and how many are approved it’s possible that healthy, under 65, non essential workers could start being offered the vaccine.
And depending on how many people actually want the vaccine and how many are approved it’s possible that healthy, under 65, non essential workers could start being offered the vaccine.
It varies by state but I expect most will at least roughly follow CDC guidelines. There will probably be variance in who is considered essential and who gets it after essential works, at risk, and 65+. At least some places are looking to start vaccinate younger people who are more likely to spread and only then do other older age groups.
Pretty much every state has a publicly available vaccine plan that you can read. The variance is pretty big even though it mostly follows the same progression. My stepdad can get the vaccine in phase 1b in his state, but not my mom. The state over from her my mom could get it in phase 1b, but not my stepdad.
My fiancée's parent's can't get it until phase 3 in their state, but they could both get it in phase 1b in my parent's state.
My fiancée's parent's can't get it until phase 3 in their state, but they could both get it in phase 1b in my parent's state.
Relatively small differences in the rules can certainly affect one's position in line quite a bit. For example, an otherwise not at particular risk 60 year old is actually going to be pretty close to the end of the line in a lot of places (even though they may count as "elderly" elsewhere).
That's true. States seems to be split on 60 vs 65 as the age cutoff for healthy adults.
The plans are expect to change as/if other vaccines become available. If the other vaccines in the pipeline get approved on the expected best case schedule we will be vaccinating anyone who wants it starting march. If there are unexpected issues things could take longer (the UK could still discover something and withdraw Pfizers' approval as a worst case)
I thought we were constrained by supply chain issues? Even if a vaccine was approved that didn't require ultra-low temperature storage, we need glass vials, etc.
Most of the supplies are very common. We make enough glass vials to contain all covid vaccines many times over - they are used for many other medical processes. There are supply chain issues with some of the chemicals needed for mRNA vaccines. I'm sure other vaccines have a different set of chemicals in short supply. Over all, the supplies that apply to all vaccines are well supplied.
Average people will be getting vaccines long before May. That just sounds like naysaying for the sake of naysaying. Or maybe you have inside info about which additional vaccines will be granted approval and when?
> The US vaccination plan
No such thing, AFAIK
No such thing, AFAIK
Good chance that there is significant overlap between anti-maskers and anti-vaxxers.
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Generalized category labelling is not helpful though it may be enjoyable. We can ignore stalwarts of either extreme camp while taking note of, for instance, the measured tone of the Danish study on mask wearing.
...
Most people working without air conditioning are in a job where they should have a mask that is a lot more uncomfortable than a simple N95! There are a lot of chemicals that a N95 won't filter and those are typically used by the types of people who don't have air conditioning.
All countries will have covid forever[0]: it's an endemic disease to nearly all continents now, much like the flu or aids.
[0]for values of "forever" that don't go into the far future where viruses may have a cure or an effective form of erradication.
[0]for values of "forever" that don't go into the far future where viruses may have a cure or an effective form of erradication.
The reason we have AIDS is because vaccination against HIV is very difficult and expensive. I don’t see how this generalises to all viruses? Several viruses have been eradicated, and several more have been effectively eradicated in countries with functioning healthcare
Australia doesn’t have it. Wasn’t impossible, just had to stop air travel and lockdown for a period. Now the only people with COVID are returned Australian travellers from overseas who have to go on hotel quarantine
Yeah but for how long? Unless Australia is willing to keep screening all arrivals and containing outbreaks indefinitely, Covid is gonna start circulating there at some point.
Require proof of vaccine to come to Austraila. Native population mostly vaccinated. Even if someone did manage to get in with covid, it might not spread particularly easily.
Sure covid will probably continue to exist, just like H1N1 exists
Sure covid will probably continue to exist, just like H1N1 exists
> Sure covid will probably continue to exist, just like H1N1 exists
Flu immunity only lasts 6 months.
COVID immunity seems to already be longer than Flu / H1N1 immunity.
Now if COVID immunity is only 1-year or 2-years, then yes, it will flare up over time. But if COVID immunity is like 5 years or 10 years, then we can pretty much forget-about-it after the vaccine.
No one knows how long the immunity is, aside from lasting longer than any test so far.
Flu immunity only lasts 6 months.
COVID immunity seems to already be longer than Flu / H1N1 immunity.
Now if COVID immunity is only 1-year or 2-years, then yes, it will flare up over time. But if COVID immunity is like 5 years or 10 years, then we can pretty much forget-about-it after the vaccine.
No one knows how long the immunity is, aside from lasting longer than any test so far.
We still haven't eradicated measles despite a vaccine giving lifelong immunity so I suspect covid won't be eradicated any time soon. It won't be a problem for the vast majority of people either though
What do you mean flu immunity only lasts 6mo? As I understand it, flu vaccines are done yearly due to mutations rendering the vaccine impotent for the next strain. However, it seems like you're implying that the vaccine "wears off" or something.
What do you mean?
What do you mean?
https://www.cdc.gov/flu/prevent/keyfacts.htm
> However, getting vaccinated early (for example, in July or August) is likely to be associated with reduced protection against flu infection later in the flu season, particularly among older adults
August / July is too early, people's flu immunity wears off before the end of the season. This is well known.
> However, getting vaccinated early (for example, in July or August) is likely to be associated with reduced protection against flu infection later in the flu season, particularly among older adults
August / July is too early, people's flu immunity wears off before the end of the season. This is well known.
Thanks for the share. From the link:
> Why do I need a flu vaccine every year? A flu vaccine is needed every season for two reasons. First, a person’s immune protection from vaccination declines over time, so an annual vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, flu vaccines may be updated from one season to the next to protect against the viruses that research suggests may be most common during the upcoming flu season. For the best protection, everyone 6 months and older should get vaccinated annually.
> Why do I need a flu vaccine every year? A flu vaccine is needed every season for two reasons. First, a person’s immune protection from vaccination declines over time, so an annual vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, flu vaccines may be updated from one season to the next to protect against the viruses that research suggests may be most common during the upcoming flu season. For the best protection, everyone 6 months and older should get vaccinated annually.
Yeah, you're not wrong, but neither am I. Both effects happen. The flu has unusually short immunity in humans: most diseases have an immunity that lasts longer than that.
A big worry about COVID19 was the length of immunity. As a novel disease, no one knew how long human immunity would last. Fortunately, it seems to be for a long time (more than 8 months, which is the length of time these studies have been going). As such, we know COVID19 immunity is "longer than the flu", already.
A big worry about COVID19 was the length of immunity. As a novel disease, no one knew how long human immunity would last. Fortunately, it seems to be for a long time (more than 8 months, which is the length of time these studies have been going). As such, we know COVID19 immunity is "longer than the flu", already.
Qantas (the Australian airline) has already announced that they intend to require COVID vaccination as a condition for boarding international flights: https://www.channelnewsasia.com/news/world/qantas-covid-19-v...
Australia is also not even letting citizens leave the country without special permission. I don't see them loosening up until there's actual herd immunity via vaccination in the country.
Australia is also not even letting citizens leave the country without special permission. I don't see them loosening up until there's actual herd immunity via vaccination in the country.
I think Australia lets you leave. It’s just really hard to get back.
They could make proof of vaccination an entry requirement. Combine that with widespread domestic vaccination and you've got a very good chance of containing any infections that make it into the country.
vaccination doesn't mean you cannot get the virus and spread it around. it protects you from the effects of Covid-19, the disease, caused by your body's reaction to the virus.
Those vaccinated, because they have less symptoms, less coughing basically, might not spread it around as much, but we don't know that yet. Remember asymptomatic spreading is a big concern for this virus.
Those vaccinated, because they have less symptoms, less coughing basically, might not spread it around as much, but we don't know that yet. Remember asymptomatic spreading is a big concern for this virus.
You're right that the recent efficacy studies of the COVID vaccines only demonstrated protection from the disease. That doesn't mean that they do not prevent spreading the disease, only that we don't know whether they do. Presumably the reason for this choice of endpoint is that we can detect sickness, but we can't reliably detect transmission.
If I may pick another nit, it's not asymptomatic but presymptomatic that seem to be the major concern, from what I've heard: that is, people who spread the disease will eventually show symptoms (usually within a day or two). The balance of evidence seems to suggest that people with viral loads that never get high enough to cause illness are probably not enough to cause a significant number of transmissions, but we will have to wait for widespread vaccination to confirm it.
If I may pick another nit, it's not asymptomatic but presymptomatic that seem to be the major concern, from what I've heard: that is, people who spread the disease will eventually show symptoms (usually within a day or two). The balance of evidence seems to suggest that people with viral loads that never get high enough to cause illness are probably not enough to cause a significant number of transmissions, but we will have to wait for widespread vaccination to confirm it.
This is getting downvotes, but it is at least somewhat correct.
> it protects you from the effects of Covid-19, the disease, caused by your body's reaction to the virus.
There isn't really evidence either way for this. To quote Nature[1]:
"Tests on more than 43,000 people have shown that the Pfizer vaccine is 95% effective at preventing disease"
> vaccination doesn't mean you cannot get the virus and spread it around.
This might be true:
"But none has demonstrated that it prevents infection altogether, or reduces the spread of the virus in a population. This leaves open the chance that those who are vaccinated could remain susceptible to asymptomatic infection — and could transmit that infection to others who remain vulnerable. “In the worst-case scenario, you have people walking around feeling fine, but shedding virus everywhere"
[1] https://www.nature.com/articles/d41586-020-03441-8
> it protects you from the effects of Covid-19, the disease, caused by your body's reaction to the virus.
There isn't really evidence either way for this. To quote Nature[1]:
"Tests on more than 43,000 people have shown that the Pfizer vaccine is 95% effective at preventing disease"
> vaccination doesn't mean you cannot get the virus and spread it around.
This might be true:
"But none has demonstrated that it prevents infection altogether, or reduces the spread of the virus in a population. This leaves open the chance that those who are vaccinated could remain susceptible to asymptomatic infection — and could transmit that infection to others who remain vulnerable. “In the worst-case scenario, you have people walking around feeling fine, but shedding virus everywhere"
[1] https://www.nature.com/articles/d41586-020-03441-8
How can the vaccine prevent entry of the virus in cells, yet the virus can still replicate? I can’t understand why they state we don’t know, because of how I image viruses and vaccination works. Can someone help me understand this paradox?
https://www.youtube.com/watch?v=zQGOcOUBi6s
Here's a nice video on the immune system that might help you out. Their other videos on the immune system, the complement system, and viruses might also be helpful. Not the most technical deep dives, but good, abstracted explanations.
In short, I don't think the vaccine prevents entry of the virus into the cells. That still happens, as it's a mechanical protein interaction (as far as I know). However, the vaccine (mRNA ones at least) work by producing the protein on the outside of the virus and putting that in your system, so your immune system learns how to respond. At least that's my mile-high interpretation.
Here's a nice video on the immune system that might help you out. Their other videos on the immune system, the complement system, and viruses might also be helpful. Not the most technical deep dives, but good, abstracted explanations.
In short, I don't think the vaccine prevents entry of the virus into the cells. That still happens, as it's a mechanical protein interaction (as far as I know). However, the vaccine (mRNA ones at least) work by producing the protein on the outside of the virus and putting that in your system, so your immune system learns how to respond. At least that's my mile-high interpretation.
I presume it's because of the inadvertent time delay in response by the immune system, during which time it would be possible to spread the virus.
And are you going to keep your borders closed forever?
And i guarantee some people still have it. There's no way it's been eradicated completely. All it takes is for one infected person to visit 2 people, and those 2 people to visit 2 others.
And i guarantee some people still have it. There's no way it's been eradicated completely. All it takes is for one infected person to visit 2 people, and those 2 people to visit 2 others.
And presumably that's been happening for months, yet there are limited outbreaks and they are swiftly contained through contact tracing and quarantine.
Victoria was swamped yet has not had a case for 30 days now. Cross-border travel varies depending on the status of each state, but is tracked and quarantine enforced at various levels if it's available.
Testing is freely available and fairly fast.
Nationwide, there is currently one locally acquired case over the last 7 days, and 74 from overseas in the same period.
Presumably we'll bubble with NZ at some point and carefully go from there, plus see how the availability of vaccines starts to change the equation beyond that. In my circles, people are keen to travel again, but everyone is pretty matter of fact about the situation and curious about timings rather than desperate to open up.
Victoria was swamped yet has not had a case for 30 days now. Cross-border travel varies depending on the status of each state, but is tracked and quarantine enforced at various levels if it's available.
Testing is freely available and fairly fast.
Nationwide, there is currently one locally acquired case over the last 7 days, and 74 from overseas in the same period.
Presumably we'll bubble with NZ at some point and carefully go from there, plus see how the availability of vaccines starts to change the equation beyond that. In my circles, people are keen to travel again, but everyone is pretty matter of fact about the situation and curious about timings rather than desperate to open up.
Helps to have no land borders, not saying Australia didn’t do a great job curbing it ..
Thailand has done an even better job, with just under 4,200 infections total since January. It has land borders with four other countries, the most porous of which is Myanmar. Very recently there have been some cases of infected people crossing over illegally from the latter; health authorities have been doing very thorough contact tracing so it remains to be seen if this will escalate. But last week was the first time in months there was more than a handful of cases nationwide, excluding foreign travelers in quarantine.
Why has it worked so well here? I don't know the full answer, but by and large people have been very responsible. The last time I was at an airport, back in early February, every single person was wearing a mask, and in lots of public places the majority of people continue to do so. Mask wearing has not been politicised here. Also every shopping mall and most restaurants/public places scan you for temperature on entry and have a book where you can (optionally) write down your name or register with an app to be notified if it is later discovered an infected person has been there the same day you were.
Why has it worked so well here? I don't know the full answer, but by and large people have been very responsible. The last time I was at an airport, back in early February, every single person was wearing a mask, and in lots of public places the majority of people continue to do so. Mask wearing has not been politicised here. Also every shopping mall and most restaurants/public places scan you for temperature on entry and have a book where you can (optionally) write down your name or register with an app to be notified if it is later discovered an infected person has been there the same day you were.
Does it really? Has it been found that a significant source of infections was illegal immigration? Or that without it there would not have already been internal spreading?
Doesn't matter. If you don't have covid, and nobody comes in, you won't get covid.
But that's not feasible in most countries.
Austrailia and NZ don't rely on a just-in-time cross border economy like the US and Europe. Goods arrive after being on boats which have been off shore for days or weeks.
Compare with the US-Canada "border closure", where thousands of trucks, and their drivers, have crossed each way every day all year.
But that's not feasible in most countries.
Austrailia and NZ don't rely on a just-in-time cross border economy like the US and Europe. Goods arrive after being on boats which have been off shore for days or weeks.
Compare with the US-Canada "border closure", where thousands of trucks, and their drivers, have crossed each way every day all year.
Canada-US could do what they already do with trains: crew change at the border.
Or even trailer drop-off and pick-up for no-chance-of-personal-contact changes.
They just choose not to.
Or even trailer drop-off and pick-up for no-chance-of-personal-contact changes.
They just choose not to.
That's still orders of magnitude more goods crossing a border without a quarentine period than you get from air freight to Aus/NZ
I don’t think the issue is quarantining/isolation of goods, but the people transporting it.
Canadian cross-border truckers arriving back from ??? USA are largely exempt from quarantine requirements upon return.
Canadian cross-border truckers arriving back from ??? USA are largely exempt from quarantine requirements upon return.
That's what is happening at this moment in Thailand. There were no local transmissions for many months. Borders are closed and anyone coming into the country has to go directly to 14 day quarantine and test clean before they get out. But then some Thais went to Myanmar and snuck back into Chiang Mai in northern Thailand illegally. They were infected and have now spread the infection locally in Thailand to at least a few people. Some cases took flights to Bangkok. There is a frantic effort to track and trace everyone who might have been exposed.
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It's likely this will change next year when Australia lifts quarantining. It will be considered an acceptable risk given that most people will not be vulnerable to it.
This! I was thinking about this recently. How the politicians have failed to implement such simple policies?
Blame the World Health Organization.
> Countries may gain time in the short-term as they limit travel to fight the new coronavirus pandemic, but the World Health Organization thinks overall that “it doesn't help to restrict movement," a top adviser to the U.N. health agency's chief said Thursday.
https://www.euronews.com/2020/03/13/world-health-organizatio...
> Countries may gain time in the short-term as they limit travel to fight the new coronavirus pandemic, but the World Health Organization thinks overall that “it doesn't help to restrict movement," a top adviser to the U.N. health agency's chief said Thursday.
https://www.euronews.com/2020/03/13/world-health-organizatio...
It probably depends on when you do it too. If it’s already widespread in your population, closing borders isn’t going to help much.
That was in March. The messaging from Jan was pretty much the same, if not even more lax. The WHO is to be blamed significantly for not communicating properly.
You should provide sources for claims like this or at least claims stated in this way. The actual real truth is, like most things with this virus that showed up a few months ago, nobody knows for sure.
The 91 year old gentleman in the linked video just called the hospital and asked for the vaccine, puts to shame how paranoid and conspiracy theory focused a lot of people are. It is a breath of fresh air to see someone just leave the worrying about safety to experts, rather than thinking they know best from some arbitrary Twitter thread.
https://twitter.com/CNN/status/1336352635935469574?s=20
https://twitter.com/CNN/status/1336352635935469574?s=20
A 90 year old woman in a nursing home is not spreading COVID. Wouldn't it make more sense to give this to people who are most at risk of spreading it, not dying from it? Why wouldn't we go at the root cause of the pandemic; young healthy asymptomatic spreaders?
Just as a side note, asymptomatic spread is a contested topic. If asymptomatic spread were a major driver of infection, this would be the first respiratory virus to work that way.
Sources:
- Nature study, 20th Nov https://www.nature.com/articles/s41467-020-19802-w
- Maria Van Kerkhove, head of the WHO Emerging Diseases and Zoonosis unit https://www.youtube.com/watch?v=NQTBlbx1Xjs
- Fauci in 2018 https://www.youtube.com/watch?v=vrAvjU2LBkg&feature=emb_titl...
Sources:
- Nature study, 20th Nov https://www.nature.com/articles/s41467-020-19802-w
- Maria Van Kerkhove, head of the WHO Emerging Diseases and Zoonosis unit https://www.youtube.com/watch?v=NQTBlbx1Xjs
- Fauci in 2018 https://www.youtube.com/watch?v=vrAvjU2LBkg&feature=emb_titl...
My casual understanding was that there werent really any asymptomatic spreaders, just "not symptomatic yet". Is this wrong?
That’s just word play. I’m asymptotic today, symptomatic tomorrow.
I, asymptotic young person with nCoV 2, am spreading it today. The “yet” part is completely irrelevant to this point in time.
I, asymptotic young person with nCoV 2, am spreading it today. The “yet” part is completely irrelevant to this point in time.
This is one of those situations where the overlap between colloquial and technical usage can cause confusion when one leaks into the other.
In colloquial usage, asymptomatic encompasses presymptomatic. In technical usage, they are different.
If you develop symptoms, then when you were a carrier before then, you were presymptomatic, rather than asymptomatic.
In colloquial usage, asymptomatic encompasses presymptomatic. In technical usage, they are different.
If you develop symptoms, then when you were a carrier before then, you were presymptomatic, rather than asymptomatic.
I'm not aware of stats relating to how many asymptomatic individuals go on to develop full blown symptomatic Covid-19. My assumption is that testing PCR positive while remaining asymptomatic the entire time is by far the most common experience.
Of course, whether you go on to develop symptoms or not, its still highly pertinent information if asymptomatic spread is not a major driver of infection. As long as you self isolate upon symptom onset that should be enough. It does call into question whether isolating the apparently healthy is an evidence-based public health policy intervention though.
Of course, whether you go on to develop symptoms or not, its still highly pertinent information if asymptomatic spread is not a major driver of infection. As long as you self isolate upon symptom onset that should be enough. It does call into question whether isolating the apparently healthy is an evidence-based public health policy intervention though.
Truly asymptomatic spread is not a major driver of infection. There are been some major public relations problems when an organization said this, and were mistaken to mean pre-symptomatic, but the science is pretty clear.
We used to think true asymptomatic infections (never develop any symptoms but test positive) were ~50% of those infected. More recent research puts it at closer to ~20%. Again, some reporting bungled this by reporting studies from controlled populations (like a cruise ship) before they knew if cases were asymptomatic or pre-symptomatic, causing people to quote the number as the former, when it was really a mix.
COVID spreads like wildfire by pre-symptomatic people. There are mountains of evidence to support this. Spread by asymptomatic people is speculation.
> Of course, whether you go on to develop symptoms or not, its still highly pertinent information if asymptomatic spread is not a major driver of infection.
Not sure, but I think you may be using the word "asymptomatic" to denote pre-symptomatic in this sentence.
> As long as you self isolate upon symptom onset that should be enough.
It is not enough.
We used to think true asymptomatic infections (never develop any symptoms but test positive) were ~50% of those infected. More recent research puts it at closer to ~20%. Again, some reporting bungled this by reporting studies from controlled populations (like a cruise ship) before they knew if cases were asymptomatic or pre-symptomatic, causing people to quote the number as the former, when it was really a mix.
COVID spreads like wildfire by pre-symptomatic people. There are mountains of evidence to support this. Spread by asymptomatic people is speculation.
> Of course, whether you go on to develop symptoms or not, its still highly pertinent information if asymptomatic spread is not a major driver of infection.
Not sure, but I think you may be using the word "asymptomatic" to denote pre-symptomatic in this sentence.
> As long as you self isolate upon symptom onset that should be enough.
It is not enough.
If a person has no symptoms, I think it is reasonable to say they are "asymptomatic".
There is absolutely a difference between 'yet to have' and 'never will have' but I think it is potentially confusing to attempt to delineate between asymptomatic and "pre-symptomatic".
The main concern with messaging that causes confusion in this regard is that a superficial reading of "asymptomatic doesn't spread virus" would imply that if you aren't symptomatic, you aren't a danger.
There is absolutely a difference between 'yet to have' and 'never will have' but I think it is potentially confusing to attempt to delineate between asymptomatic and "pre-symptomatic".
The main concern with messaging that causes confusion in this regard is that a superficial reading of "asymptomatic doesn't spread virus" would imply that if you aren't symptomatic, you aren't a danger.
Every symptomatic person was asymptomatic before they started getting their first symptoms. It might have been few days that they already had the virus on their mucus membranes.
Asymptomatic individuals never develop any symptoms.
And the viral load is high two days before the symptoms onset. If you want a proper RCT about it, good luck approving it in an ethics committee.
And the viral load is high two days before the symptoms onset. If you want a proper RCT about it, good luck approving it in an ethics committee.
This is missing the point and reeks of intellectual dishonesty.
Asymptomatic has a strict definition. You get the virus and nothing happens to you. This is what the WHO and Fauci are referring to.
But most "asymptomatic" cases aren't. They are either paucisymptomatic (you have mild symptoms - maybe too mild to notice) or pre-symptomatic.
Obviously if people were only contagious if showing symptoms, the pandemic wouldn't be.
Asymptomatic has a strict definition. You get the virus and nothing happens to you. This is what the WHO and Fauci are referring to.
But most "asymptomatic" cases aren't. They are either paucisymptomatic (you have mild symptoms - maybe too mild to notice) or pre-symptomatic.
Obviously if people were only contagious if showing symptoms, the pandemic wouldn't be.
I made a new point, so am I missing my own point? Confused.
> Obviously if people were only contagious if showing symptoms, the pandemic wouldn't be.
I don't think that is obviously the case at all. It would have to be proved. The dominant vectors of contagion are not yet well understood - we could be dealing with very highly infectious airborne virus, that is capable of spreading widely from a relatively small number of symptomatic and pre-symptomatic super spreaders.
The fact remains that current public health interventions orientate around isolating individuals whether they are symptomatic, asymptomatic or paucisymptomatic. Moreover, to greater and lesser degrees we also isolate the healthy, assuming them to be asymptomatic in an abundance of caution. Considering the negative non-covid related knock on effects of these policies its at least worth investigating isn't it?
> Obviously if people were only contagious if showing symptoms, the pandemic wouldn't be.
I don't think that is obviously the case at all. It would have to be proved. The dominant vectors of contagion are not yet well understood - we could be dealing with very highly infectious airborne virus, that is capable of spreading widely from a relatively small number of symptomatic and pre-symptomatic super spreaders.
The fact remains that current public health interventions orientate around isolating individuals whether they are symptomatic, asymptomatic or paucisymptomatic. Moreover, to greater and lesser degrees we also isolate the healthy, assuming them to be asymptomatic in an abundance of caution. Considering the negative non-covid related knock on effects of these policies its at least worth investigating isn't it?
> we could be dealing with very highly infectious airborne virus, that is capable of spreading widely from a relatively small number of symptomatic and pre-symptomatic super spreaders.
The calculated R0 does not support this theory. Measles works this way. R0 for Measles is > 10
> that current public health interventions orientate around isolating individuals whether they are symptomatic, asymptomatic or paucisymptomatic
Everywhere, the restrictions are higher if you were tested and/or is suspected of having Covid. Of course a lot of people DNGAF about the restrictions, which is part of the problem.
Again, if your theory that people showing no symptoms do not transmit the disease then it should be super easy to go around and start finding people spreading it. But it isn.t
The calculated R0 does not support this theory. Measles works this way. R0 for Measles is > 10
> that current public health interventions orientate around isolating individuals whether they are symptomatic, asymptomatic or paucisymptomatic
Everywhere, the restrictions are higher if you were tested and/or is suspected of having Covid. Of course a lot of people DNGAF about the restrictions, which is part of the problem.
Again, if your theory that people showing no symptoms do not transmit the disease then it should be super easy to go around and start finding people spreading it. But it isn.t
I followed the New Zealand press conferences very closely and so often the initial story was this person had no symptoms, total surprise to them that they had the virus, and then a day later oh, well, actually they did have some symptoms but they didn't realise it was COVID-19...
People will say to themselves well, it's just a cough right? Just a cough. I can't have COVID-19 that's something other people get, those people are sick but I'm healthy, this is just a cough. And that allows the virus to spread.
People will say to themselves well, it's just a cough right? Just a cough. I can't have COVID-19 that's something other people get, those people are sick but I'm healthy, this is just a cough. And that allows the virus to spread.
> They are either paucisymptomatic (you have mild symptoms - maybe too mild to notice)
Or you notice them but because they also match symptoms of colds and allergies, and you’ve been getting them on and off for months, you assume they aren’t COVID.
I don’t think there has been an interval longer than a week since February during which I didn’t have at least a couple symptoms that could have been COVID.
I’ve not had the taste/smell loss, and all my contact with other people has been masked and brief, and I’m in an area where spread has been low, so I’ve probably not had it, but I wish we had widespread cheap testing so I could know.
Or you notice them but because they also match symptoms of colds and allergies, and you’ve been getting them on and off for months, you assume they aren’t COVID.
I don’t think there has been an interval longer than a week since February during which I didn’t have at least a couple symptoms that could have been COVID.
I’ve not had the taste/smell loss, and all my contact with other people has been masked and brief, and I’m in an area where spread has been low, so I’ve probably not had it, but I wish we had widespread cheap testing so I could know.
> Or you notice them but because they also match symptoms of colds and allergies, and you’ve been getting them on and off for months, you assume they aren’t COVID.
Exactly. I have occasionally runny nose combined with sporadic sneezes and coughs pretty much every winter. If someone like my had so "mild" COVID symptoms they would consider themselves asymptomatic (paucisymptomatic?), and rightfully so. (My actual COVID symptoms were not as mild, but not very serious either.)
Exactly. I have occasionally runny nose combined with sporadic sneezes and coughs pretty much every winter. If someone like my had so "mild" COVID symptoms they would consider themselves asymptomatic (paucisymptomatic?), and rightfully so. (My actual COVID symptoms were not as mild, but not very serious either.)
> I don’t think there has been an interval longer than a week since February during which I didn’t have at least a couple symptoms that could have been COVID.
It's remarkable the number of people anecdotally reporting similar symptoms - often out of character for otherwise robustly healthy individuals. I'm guessing some sort of psychosomatic response to the year's stresses.
It's remarkable the number of people anecdotally reporting similar symptoms - often out of character for otherwise robustly healthy individuals. I'm guessing some sort of psychosomatic response to the year's stresses.
Is it that out of character though?
I have been having the same, but the main reason why I notice it now is that every time I have any symptom, even the mildest of them, I take notice and consider the possibility of Covid, whereas in past years I would forget about them if even notice at all.
For context, I'm a fairly healthy individual who hasn't seen a GP or other medical doctor in at least a couple years, probably longer. Last time I've been to one was because of exercise-related injuries.
I have been having the same, but the main reason why I notice it now is that every time I have any symptom, even the mildest of them, I take notice and consider the possibility of Covid, whereas in past years I would forget about them if even notice at all.
For context, I'm a fairly healthy individual who hasn't seen a GP or other medical doctor in at least a couple years, probably longer. Last time I've been to one was because of exercise-related injuries.
> every time I have any symptom, even the mildest of them, I take notice and consider the possibility of Covid
This is hypochondria isn't it? A pathology in its own right, no doubt caused by current events.
This is hypochondria isn't it? A pathology in its own right, no doubt caused by current events.
Of course it isn't. I don't even bother about mild symptoms, much less go see a doctor or look for a cure. I just take note.
It's not hypochondria, it's simple awareness.
It's not hypochondria, it's simple awareness.
Oh I totally understand you
That being said it seems the most specific symptom is loss of smell/taste so unless you have that it's probably something else (disclaimer: not a doctor and this is not medical advice)
That being said it seems the most specific symptom is loss of smell/taste so unless you have that it's probably something else (disclaimer: not a doctor and this is not medical advice)
12 months in, I'd say we can already claim it more than "reeks": it is full-blown intellectual dishonesty. Viral load peeks before symptoms onset, we have quite a few case studies of transmission, but these people apparently want some dozens of RCTs before admitting it.
In Ontario (as elsewhere), there's been a giant ramp up in cases since the start of September, with an accompanying discussion about whether or not reopening schools is the cause. But a recent testing blitz at a single Toronto school uncovered 26 infected individuals scattered across 18 classrooms:
https://www.theglobeandmail.com/canada/toronto/article-stude...
Still not obvious one way or the other about whether these students and staff are spreading it amongst themselves or if they all got it from other symptomatic cases in the community and independently brought it to school with them. But either way, it's sobering how much of it is going undetected.
https://www.theglobeandmail.com/canada/toronto/article-stude...
Still not obvious one way or the other about whether these students and staff are spreading it amongst themselves or if they all got it from other symptomatic cases in the community and independently brought it to school with them. But either way, it's sobering how much of it is going undetected.
"Wouldn't it make more sense to give this to people who are most at risk of spreading it, not dying from it?"
It wouldn't make any sense at all. The reason is that not only do older people have a greater risk of dying from Covid, they also have a much higher risk of being hospitalized[1], and remember the justification for the extreme measures we've taken and continue to take is the fear we will overwhelm our health care systems.
[1] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investi...
It wouldn't make any sense at all. The reason is that not only do older people have a greater risk of dying from Covid, they also have a much higher risk of being hospitalized[1], and remember the justification for the extreme measures we've taken and continue to take is the fear we will overwhelm our health care systems.
[1] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investi...
They looked at that, and modelled what would save the most life-years based on limited speed that the vaccine can be deployed, how well the vaccine works in stopping bad effects (i.e. death), and how well it works in stopping spread.
> JCVI has considered a number of different vaccination strategies, including those targeting transmission and those targeted at providing direct protection to persons most at risk. In order to interrupt transmission, mathematical modelling indicates that we would need to vaccinate a large proportion of the population with a vaccine which is highly effective at preventing infection (transmission). At the start of the vaccination programme, good evidence on the effects of vaccination on transmission will not be available, and vaccine availability will be more limited. The best use of available vaccine will also, in part, be dependent on the point in the pandemic the UK is at. Given the current epidemiological situation in the UK, all evidence indicates that the best option for preventing morbidity and mortality in the initial phase of the programme is to directly protect persons most at risk of morbidity and mortality.
https://assets.publishing.service.gov.uk/government/uploads/...
> JCVI has considered a number of different vaccination strategies, including those targeting transmission and those targeted at providing direct protection to persons most at risk. In order to interrupt transmission, mathematical modelling indicates that we would need to vaccinate a large proportion of the population with a vaccine which is highly effective at preventing infection (transmission). At the start of the vaccination programme, good evidence on the effects of vaccination on transmission will not be available, and vaccine availability will be more limited. The best use of available vaccine will also, in part, be dependent on the point in the pandemic the UK is at. Given the current epidemiological situation in the UK, all evidence indicates that the best option for preventing morbidity and mortality in the initial phase of the programme is to directly protect persons most at risk of morbidity and mortality.
https://assets.publishing.service.gov.uk/government/uploads/...
1. Most nursing homes have more than one elderly resident, living in close contact. Your 90 year old woman can spread it to them.
2. By what mechanism do you imagine it got into the nursing home without that mechanism also working to spread it to outside?
2. By what mechanism do you imagine it got into the nursing home without that mechanism also working to spread it to outside?
It's not yet known whether the Pfizer vaccine prevents an infected person from transmitting the infection to other people [1]. But there is robust evidence that is does prevent an immunised person from becoming ill.
[1] https://www.nature.com/articles/d41586-020-03441-8
[1] https://www.nature.com/articles/d41586-020-03441-8
Could someone please explain how this can be the case? I understand the vaccine works by stimulating antibody production, which prevent you from becoming ill by binding to the virus and disabling it should it enter your system. How then could the virus be spread further if it's already been disabled?
You are asking why an already infected person who receives the vaccine may still be able to spread it? The virus is still able to spread while the body fights it. In fact I'm not even sure there is a significant advantage of giving the vaccine to someone who already has the virus (as after all the vaccine teaches the body what the virus looks like and therefore how it can be tackled). This specific vaccine looks as if it simulates certain aspects of the virus, therefore not entirely necessary for someone who already has the virus I believe. But yeah - it's not like you get jabbed and you have instant immunity. Your body needs to learn to fight it, and then actually fight it - and if you already have it you are still infectious during this period.
The vaccine teaches your immune system to respond to a particular protein that surrounds the virus. If you contract the virus you are still infectious until it can kill all of the virus. The time between the immune response and OG infection can mean the virus has time to replicate and spread/ be shed I’m guessing.
Different tissues are protected by different types of antibodies. A vaccine injected subcutaneously will mostly induce an IgG response, a type of antibody present in blood and extracellular fluid. This could still possibly allow a virus to infect mucous membranes, which rely on a different type of antibody, sIgA[0], to protect them. If this is the case, you could be protected from having a serious systemic infection, but could still suffer a mild upper respiratory infection, and be infectious until the immune system mounted defense in the mucous membranes.
Some flu vaccines come in the form of a nasal spray, which does induce an IgA response. I don't know why COVID vaccines are administered parenterally instead, I'm sure there are good technical reasons. Given the virus's possible neurological involvement, maybe it's a bad idea to deposit it so close to the olfactory bulb.
0: https://en.wikipedia.org/wiki/Immunoglobulin_A#Secretory_IgA
Some flu vaccines come in the form of a nasal spray, which does induce an IgA response. I don't know why COVID vaccines are administered parenterally instead, I'm sure there are good technical reasons. Given the virus's possible neurological involvement, maybe it's a bad idea to deposit it so close to the olfactory bulb.
0: https://en.wikipedia.org/wiki/Immunoglobulin_A#Secretory_IgA
Virus can infect cells in areas that are difficult to reach for immune system - epithelial cells lining the nasal mucosa for example - but they still would produce viral particles that could be sneezed on someone else.
Indeed this paper found association between viral load and symptoms - hospitalized patients are shedding less virus
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332909/
Indeed this paper found association between viral load and symptoms - hospitalized patients are shedding less virus
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332909/
There is the virus replicating itself in a body, which leads to the body being able to spread the virus to others. And there is the body getting sick. The second often follows the first, but the two are not necessarily connected, which is proven by asymptomatic spreaders. In the vaccine phase 3 tests, it was only determined whether people get sick, and the vaccine was found to prevent 95% of people from getting sick. It was not tested whether the viral load in vaccinated people who don't get sick, but still had virus exposure, was high enough for a real likelihood of transmission to others. This now results in those warnings regarding potential transmission even through vaccinated people: scientifically that's a possibility that hasn't been ruled out.
However, the science is the easy part here. It gets complicated once politics comes into play. Pretty much all scientists I've spoken or listened to say that they assume that the spread will most likely be at least severely limited through the vaccines. That's because they don't have any other explanation than a reduced viral load that could explain how the vaccines actually work in preventing sickness, and a reduced viral load would also mean a reduced spreading capability. However, not knowing something does not mean it can't exist: it is not impossible for there to be some unknown way in which these vaccines may potentially prevent sickness without also limiting viral spread. And scientists usually want to be scientifically correct, so they don't go out and declare something as fact that they just carefully "assume" to be the case.
This "known unknown" of effectiveness in limiting viral spread is now actively being used by politics, especially those people coordinating protective measures in governments, as a convenient escape hatch out of a problematic situation. That situation is: how do you explain to someone who just got vaccinated that he/she should still adhere to all the protective measures like universal mask-wearing and limiting personal contacts? Because even though there are rational reasons for doing so (first, the vaccines need two shots and some weeks of time to actually build up protection, and second, if a significant portion of the populace is exempt from all the protective measures and their burdens, this incentivizes the remaining, non-vaccinated part to also "exempt themselves", because constraints enforced on all citizens are much easier to follow than constraints only enforced on half of all citizens) there will be a strong impetus within each individual to not follow protective measures and rules anymore, once vaccinated and thus "protected" from the virus. And besides that psychological effect there's the overarching problem of the constitutional impossibility of enforcing wide-ranging limitations on constitutional rights onto people that is not justifiable anymore, once an individual in question can provably no longer spread the virus. Because of all of this, politicians (rightfully) fear the situation that we're going to be in in a few months time, when a significant part of the populace, but not enough for herd immunity, is already vaccinated. An assumption of a possibility of transmission even with vaccination is a godsend in that situation.
However, the science is the easy part here. It gets complicated once politics comes into play. Pretty much all scientists I've spoken or listened to say that they assume that the spread will most likely be at least severely limited through the vaccines. That's because they don't have any other explanation than a reduced viral load that could explain how the vaccines actually work in preventing sickness, and a reduced viral load would also mean a reduced spreading capability. However, not knowing something does not mean it can't exist: it is not impossible for there to be some unknown way in which these vaccines may potentially prevent sickness without also limiting viral spread. And scientists usually want to be scientifically correct, so they don't go out and declare something as fact that they just carefully "assume" to be the case.
This "known unknown" of effectiveness in limiting viral spread is now actively being used by politics, especially those people coordinating protective measures in governments, as a convenient escape hatch out of a problematic situation. That situation is: how do you explain to someone who just got vaccinated that he/she should still adhere to all the protective measures like universal mask-wearing and limiting personal contacts? Because even though there are rational reasons for doing so (first, the vaccines need two shots and some weeks of time to actually build up protection, and second, if a significant portion of the populace is exempt from all the protective measures and their burdens, this incentivizes the remaining, non-vaccinated part to also "exempt themselves", because constraints enforced on all citizens are much easier to follow than constraints only enforced on half of all citizens) there will be a strong impetus within each individual to not follow protective measures and rules anymore, once vaccinated and thus "protected" from the virus. And besides that psychological effect there's the overarching problem of the constitutional impossibility of enforcing wide-ranging limitations on constitutional rights onto people that is not justifiable anymore, once an individual in question can provably no longer spread the virus. Because of all of this, politicians (rightfully) fear the situation that we're going to be in in a few months time, when a significant part of the populace, but not enough for herd immunity, is already vaccinated. An assumption of a possibility of transmission even with vaccination is a godsend in that situation.
Possible "reduced viral load" by those who are vaccinated simply doesn't mean that that load is below the threshold which makes somebody not infectious. In practice, it could, for example, mean that if such persons spend two hours in the room with you they can still transmit the virus to you, whereas the non vaccinated person with the virus would transmit to you in 15 minutes. So you can't just claim that a person is 100% safe because the load is just "reduced."
Additionally, for the immune system to respond, the infection has to happen first -- the virus has to spread through the cells of your body. We already know that the people are indeed infectious before their immune system response makes the symptoms. The delay in response has to exist even among the vaccinated people.
So what is sought after is a proof of sterilizing immunity, and there's no such still. I've read that the UK plans to evaluate the evidence for that in the following months by tracking the people who get the vaccine, which sounds good.
Additionally, for the immune system to respond, the infection has to happen first -- the virus has to spread through the cells of your body. We already know that the people are indeed infectious before their immune system response makes the symptoms. The delay in response has to exist even among the vaccinated people.
So what is sought after is a proof of sterilizing immunity, and there's no such still. I've read that the UK plans to evaluate the evidence for that in the following months by tracking the people who get the vaccine, which sounds good.
There is no threshold that makes people non-infectious. Or there is, and it is zero. Because even a single virus instance can potentially infect someone else. It is extremely unlikely to happen, but not impossible.
Because of this, for practical purposes, you either have to arbitrarily set a threshold at which someone is considered non-infectious, ignoring that it is not impossible for that person to infect someone. Or you have to stop talking in absolutes entirely and just talk about probabilities.
Because of this, for practical purposes, you either have to arbitrarily set a threshold at which someone is considered non-infectious, ignoring that it is not impossible for that person to infect someone. Or you have to stop talking in absolutes entirely and just talk about probabilities.
When taking about probabilities, one usually can recognize a reasonable threshold. In practice we do exactly that with most of the medicine: there could be some small chance that somebody can have health problems because his body responds unfavorably to the medicine, but if that chance is small enough it is considered acceptable when the potential benefits overweight the potential loss when the medicine is not used, its use is allowed. If the chance is big enough (i.e. potentially too many people will be affected) such a medicine is not allowed to be used, at least with the affected group of people.
The same is with the possibility that a vaccinated person infects somebody else. There is some point behind which it could be said that some vaccine has "sterilizing immunity" even if some small level of viruses could be present somewhere. For the current vaccine, the question is if the viral load in some point after the infection is decreased at all, and if it is, how much.
At the moment, however, it's simply not known if, in this case, Pfizer vaccine provides sterilizing level of immunity, if, then when, and in which percentage of the vaccinated. At the moment more or less we just know that the vaccinated are less probable to develop symptoms. Efficacy of 95% here means only one of 20 vaccinated develops symptoms when exposed to the virus, so we know that it's also probable that at least 1 in 20, even after being vaccinated, could be able to infect somebody else while being in the "pre-symptomatic" phase (as it is believed by the researchers that one transmits the virus before one's symptoms starts). We also believe that asymptomatic are also able to transmit. We don't know how much the vaccine affects the transmission that could occur when a vaccinated person is exposed to an infected one, and then later comes in close contact with other unvaccinated persons.
The same is with the possibility that a vaccinated person infects somebody else. There is some point behind which it could be said that some vaccine has "sterilizing immunity" even if some small level of viruses could be present somewhere. For the current vaccine, the question is if the viral load in some point after the infection is decreased at all, and if it is, how much.
At the moment, however, it's simply not known if, in this case, Pfizer vaccine provides sterilizing level of immunity, if, then when, and in which percentage of the vaccinated. At the moment more or less we just know that the vaccinated are less probable to develop symptoms. Efficacy of 95% here means only one of 20 vaccinated develops symptoms when exposed to the virus, so we know that it's also probable that at least 1 in 20, even after being vaccinated, could be able to infect somebody else while being in the "pre-symptomatic" phase (as it is believed by the researchers that one transmits the virus before one's symptoms starts). We also believe that asymptomatic are also able to transmit. We don't know how much the vaccine affects the transmission that could occur when a vaccinated person is exposed to an infected one, and then later comes in close contact with other unvaccinated persons.
Because stopping the elderly from overwhelming the health infrastructure needs to be step 1.
ICU beds are extremely expensive.
ICU beds are extremely expensive.
At this age, you don't get admitted to an ICU bed
No, you do, because no matter the age, the family members still want to have a chance of survival of their loved one. My distant relative (70 year old) was in ICU for 30 days, and on ventilator for 14 days. Yes, that is a very long time for ventilator usage, and every day more on a ventilator increases the death rate probability percentage.
At the age of 90, your lungs are too fragile to be put on a ventilator. It was one of the reasons academics overestimated the number of ventilators required for COVID.
This isn't a hard-set rule, just an extra factor in triage
Edit: Do you work at the JR by any chance? Asking as another Oxford Male based nearby!
https://academic.oup.com/biomedgerontology/article/60/1/129/...
Edit: Do you work at the JR by any chance? Asking as another Oxford Male based nearby!
https://academic.oup.com/biomedgerontology/article/60/1/129/...
its really not that simple, it turned out that the stats we were working from were wrong (well done china...) but also ventilators are not great for covid patients. Its much better to slap them with oxygen.
Too fragile for a ventilator but not too fragile for ecmo.
Of course they do, as long as there's a bed available. Especially with Covid. No hospital wants to be the one that denied a patient an available ICU bed.
Well at the NHS they'd consider your approach American Overtreatment.
[citation needed]
Do you work in a hospital? do you know any ICU people? I think you are confusing palliative care with ICU
American overtreatment is busting out MRIs for a standard sprain, routine CAT scans, dishing out opiates for anything more than 2weeks
Do you work in a hospital? do you know any ICU people? I think you are confusing palliative care with ICU
American overtreatment is busting out MRIs for a standard sprain, routine CAT scans, dishing out opiates for anything more than 2weeks
[deleted]
Why not? She could contract it from a caretaker or visitor, and then spread it to the next caretaker who spreads it further.
One advantage of immunization in nursing homes is also that they can now take visitors more liberally.
Anecdotal, but several "super spread" type events near me were nursing homes. Makes some sense as there are a lot of communal facilities. People cross paths a lot, and several shifts of employees are in and out.
You are not looking at the whole picture here.
The uk is vaccinating according to risk of death, and risk of occupying a hospital bed first. Not the risk of catching or passing it.
THe big concern in this pandemic has been hospital usage. once your hospital is full everyone starts dying not just covid patients. We were about two/four weeks away from collapse in london in april.
The uk is vaccinating according to risk of death, and risk of occupying a hospital bed first. Not the risk of catching or passing it.
THe big concern in this pandemic has been hospital usage. once your hospital is full everyone starts dying not just covid patients. We were about two/four weeks away from collapse in london in april.
As a standard, the UK makes medical decisions based on QALYs saved (quality-adjusted life years).
Although you can argue that keeping hospital beds free saves a lot of QALYs, it's harder to argue that care homes have a lot of QALYs to save.
And, it's not obvious that care home patients are the first to occupy hospital beds (I'm unsure about it); care home patients with COVID have tended to die in their care home.
Although you can argue that keeping hospital beds free saves a lot of QALYs, it's harder to argue that care homes have a lot of QALYs to save.
And, it's not obvious that care home patients are the first to occupy hospital beds (I'm unsure about it); care home patients with COVID have tended to die in their care home.
> it's harder to argue that care homes have a lot of QALYs to save.
Not true at all. They may have fewer life years left, but they're orders of magnitude more likely to die from Covid, so preventing a Covid case in this population actually saves more QALYs than preventing a case in a younger healthy person, statistically speaking.
Not true at all. They may have fewer life years left, but they're orders of magnitude more likely to die from Covid, so preventing a Covid case in this population actually saves more QALYs than preventing a case in a younger healthy person, statistically speaking.
The vaccine wasn't tested for reducing spread - it was only tested for preventing symptomatic illness. We don't know yet if vaccinated people exposed to covid can spread it to others even if they don't get sick. Therefore we base our vaccination protocols on something the vaccine is proven to do, not something it might do hypothetically.
I’m sure the infectious disease specialists know what they are doing.
I wouldn't go that far. But I'd say they're doing their best with what they do know, which is going to be more comprehensive than "some guy on the Internet".
It doesn't mean they're right, or even that they're all in agreement on the best course. But they're tasked with making a decision that absolutely has to be made right now, and can't wait on getting a complete picture.
It doesn't mean they're right, or even that they're all in agreement on the best course. But they're tasked with making a decision that absolutely has to be made right now, and can't wait on getting a complete picture.
The first phase isn't to stop the spread. The initial pool of vaccinations is to lower the strain on healthcare infrastructure. Older patients are at more risk of requiring hospital stays + ICU stays.
People in homes are possibly primary vectors of spread, especially during the early days because they catch it so easily and are around others who catch it easily.
Also, the workers in the homes are put at significant risk due to this as well.
Also, the workers in the homes are put at significant risk due to this as well.
Vaccination also prevents catching it, which prevents dying from it, which this age group is much at risk at even without prior complications.
There is a heck of a lot more people who are at risk of being superspreaders, not even mentioning the huge number of middle aged people going to protests against a diseases existence. You won't get those people vaccinated. They will massively contribute to the spread.
Additionally, vaccinating risk groups in the high age category first lets you spot complications with the disease more early and it's ethically somewhat better to risk long-term vaccination issues with 90+ year olds than 20+ year olds, as one of these groups will have to suffer the consequences for a shorter time. It may sound harsh to make comparisons like that but you'll have to make decisions like that in a medical environment.
There is a heck of a lot more people who are at risk of being superspreaders, not even mentioning the huge number of middle aged people going to protests against a diseases existence. You won't get those people vaccinated. They will massively contribute to the spread.
Additionally, vaccinating risk groups in the high age category first lets you spot complications with the disease more early and it's ethically somewhat better to risk long-term vaccination issues with 90+ year olds than 20+ year olds, as one of these groups will have to suffer the consequences for a shorter time. It may sound harsh to make comparisons like that but you'll have to make decisions like that in a medical environment.
> Wouldn't it make more sense to give this to people who are most at risk of spreading it, not dying from it?
No, it makes sense to give this to people who are most at risk of spreading it to people who are most at risk of dying from it. Thus anyone in and around aged care.
No, it makes sense to give this to people who are most at risk of spreading it to people who are most at risk of dying from it. Thus anyone in and around aged care.
isn't this where most of the fatalities are happening? isnt the handling of elderly covid patients the reason a lot of people are unhappy with Cuomo and others because they turned retirement homes into morgues?
I believe this was the case at the start, I'm not sure if this is the case now however. Deaths have only recently arrived at where they were at the first peak in the US, my impression was this was because it was a less vulnerable population being infected.
While I would certainly hope that it prevents spread too, I believe that the vaccine is only proven to prevent Covid-19 (the disease), and not to prevent the spread of SARS-CoV-2 (the virus that causes it).
The vaccine isn't proven to prevent spread.
I wouldn't be surprised if there was a small political motivation here too - the gov were heavily criticized for their terrible handling of covid in care homes, with an older voter base they might want to be seen to be doing right by the care homes this time around
Nonsense. Every country I've heard about is prioritizing nursing home residents, and few of them received the level of criticism that the UK did regarding nursing home residents.
I think there is an understandable political element to this, in that people want to see a reduction in the death rate from Covid-19 and politicians are judged on the number of deaths. So vaccinating those most likely to die makes perfect sense as it'll have most impact on death rates and therefore politicians' reputations.
I believe the vaccine has not been showed to reduce transmission, it's been shown to reduce impact, i.e. she's less likely to die if someone visits her, so great for her, and her families, well-being.
Not just less likely: no one who got the vaccine in trials has died (of COVID)
If it reduces impact it also reduces impact of transmission because the patient has lower viral load. Masks have to same effect, although to a lesser degree (and obviously a different mode of operation).
>If it reduces impact it also reduces impact of transmission because the patient has lower viral load.
That's incredibly likely but it's not what the trails tested, and so we can't rely on it.
When the vaccine has been rolled out much more widely we'll be able to gather the data to test that hypothesis using surveillance data.
That's incredibly likely but it's not what the trails tested, and so we can't rely on it.
When the vaccine has been rolled out much more widely we'll be able to gather the data to test that hypothesis using surveillance data.
1. Relative risk
2. The study of the vaccine thus far evaluated immunity, not transmission; not the same thing.
3. A 90 year old is far more likely to die of the virus regardless of whether she is infectious.
2. The study of the vaccine thus far evaluated immunity, not transmission; not the same thing.
3. A 90 year old is far more likely to die of the virus regardless of whether she is infectious.
[deleted]
because the vaccine has never been proven to be able to stop asymptomatic spreads.
yeah but how do you find those people without a massive civil rights violation?
The person administering the vaccine while not wearing gloves for instance?
This is not the first person receiving it. There had been clinical studies before. It's "just" the first person after the government put some stamps on it and made it a marketing event. (And yes, marketing the fact that it is safe and vaccination helps is good!)
She is indeed the first person to get the "vaccine." The material that those in the trials received is usually being referred to as a "vaccine candidate" because it haven't passed the trials and it isn't officially approved for anything but the trials. During the randomized trials, until the data are evaluated nobody is even supposed to know who received the tested substance and who received placebo. Many people in the trials received placebo and still became infected. Some died. Outside of trials, we know that one and half million people died while the development and the trials had to be done and there weren't no vaccines at all. And eventually, not all vaccine candidates pass all the trials.
So it is definitely an event of historical significance that should be celebrated. A lot had to be done right so that all of us can now talk about this.
So it is definitely an event of historical significance that should be celebrated. A lot had to be done right so that all of us can now talk about this.
The pharma industry is one of the dodgiest of them all and requires rather red taping than hasty short paths. Remind me in two months. Will they write down the vaccination into the WHO vaccination booklet? [1] I'm not installing an app for this.
[1] https://upload.wikimedia.org/wikipedia/commons/9/9f/Internat...
[1] https://upload.wikimedia.org/wikipedia/commons/9/9f/Internat...
The British Medical Journal and Royal Society of medicine have published a number of concerns about this vaccine.
"Will covid-19 vaccines save lives? Current trials aren’t designed to tell us" https://www.bmj.com/content/371/bmj.m4037
"All these data for the different vaccines are potentially very promising, but none of the phase III trials have been published in peer reviewed journals or analysed by age group, gender and case description...
As public health professionals, we believe that the results of clinical trials, whether interim or final, should be subject to an appropriate systematic process, and then published in peer-reviewed professional journals. Reporting the covid-19 vaccine trial results in press releases before publication in journals is neither good scientific practice nor does it help to build public trust in vaccines" https://blogs.bmj.com/bmj/2020/11/27/covid-19-vaccines-where...
"When good science is suppressed by the medical-political complex, people die
Politicians and governments are suppressing science. They do so in the public interest, they say, to accelerate availability of diagnostics and treatments. They do so to support innovation, to bring products to market at unprecedented speed. Both of these reasons are partly plausible; the greatest deceptions are founded in a grain of truth. But the underlying behaviour is troubling." https://www.bmj.com/content/371/bmj.m4425