Possible vaccines/treatment(s) for Coronavirus

[2hats]

Intramuscular (inactivated) probably, largely don't - they are, so I understand, mainly designed to reduce morbidity (and largely measured against that). More recent (live, attenuated) intranasal ones show promising signs of promoting sterilising immunity (through IgA and T cell responses - which may well prove a fruitful approach for SARS-CoV-2 as well). Influenza viral release mechanics have only recently become well understood.

 

[William of Walworth]

Intranasal vaccines, which might come into play much later next year, may well prevent upper and lower respiratory tract infection and thus greatly reduce viral shedding in (what appears to be) the key infectious stage (some have already demonstrated this in primate models). This delivery mode may also only need one dose rather than a second booster, thus potentially improving uptake and reducing community spread more readily than intramuscular.

A fair bit more on the good potential for intranasal vaccines here, in this detailed article in yesterday's Observer by the consistently excellent (IMO!) Laura Spinney :

Why the race to find Covid-19 vaccines is far from over

Despite the promising news from Pfizer and Moderna, other efforts – which may be even more effective – continue around the world

There's plenty of other related discussion on immune responses and so forth in the article, good detailed science. Well worth a read -- it's a fairly long article, but worth the time I think

 

[Supine]

Breaking news

Covid-19: Oxford University vaccine is highly effective

The vaccine is cheaper than other options and easier to distribute around the world.

www.bbc.co.uk

 

[prunus]

Breaking news

Covid-19: Oxford University vaccine is highly effective

The vaccine is cheaper than other options and easier to distribute around the world.

www.bbc.co.uk

Interesting. I hope they can validate the low dose/high dose 90% efficacy suggestion in the data.

 

[cupid_stunt]

Breaking news

Covid-19: Oxford University vaccine is highly effective

The vaccine is cheaper than other options and easier to distribute around the world.

www.bbc.co.uk

I don't understand why the BBC is going with the 70% as its headline, when one low & one high does seems to produce 90% protection.

COVID-19: Oxford vaccine is up to 90% effective in preventing coronavirus, tests show

The vaccine, codenamed AZD1222, was developed at Oxford University with support from the pharmaceutical giant AstraZeneca.

news.sky.com

 

[Monkeygrinder's Organ]

I don't understand why the BBC is going with the 70% as its headline, when one low & one high does seems to produce 90% protection.

COVID-19: Oxford vaccine is up to 90% effective in preventing coronavirus, tests show

The vaccine, codenamed AZD1222, was developed at Oxford University with support from the pharmaceutical giant AstraZeneca.

news.sky.com

I guess the low/high dose group isn't big enough for them to be confident with the figures.

 

[prunus]

I guess the low/high dose group isn't big enough for them to be confident with the figures.

Yes, it’s described as a “suggestion” in the data by one of the scientists from the study, which is (ime) scientist-speak for “a long way from statistically significant.” (It can also mean “our study wasn’t designed in such a way as to address this question however if you were to manipulate the data in a certain way it could show” though that seems unlikely in this context.)

E2a: anyone found a link to the underlying data and/or study rather than press reports?

 

[prunus]

Some more good news in the detail: no hospitalisations (or severe cases) in the vaccinated population (regardless of dosing regime) (caveat: only 131 cases in total so not a huge sample); seemingly more efficacious dosing regime also appears to show reduction in asymptomatic cases (and hence asymptomatic transmission) (again I don’t think necessarily enough data to say for sure yet).

 

[Combustible]

E2a: anyone found a link to the underlying data and/or study rather than press reports?

I'm not sure any data has been released yet, but the press release from AstraZeneca has some more details

One dosing regimen (n=2,741) showed vaccine efficacy of 90% when AZD1222 was given as a half dose, followed by a full dose at least one month apart, and another dosing regimen (n=8,895) showed 62% efficacy when given as two full doses at least one month apart. The combined analysis from both dosing regimens (n=11,636) resulted in an average efficacy of 70%. All results were statistically significant (p<=0.0001). More data will continue to accumulate and additional analysis will be conducted, refining the efficacy reading and establishing the duration of protection.

Obviously the slightly concerning thing is that the group with 2 full doses with 62% efficacy is about 3 times larger than the 90% efficacy group, so it could be the margin of error on the 90% estimate is much larger.

AZD1222 vaccine met primary efficacy endpoint in preventing COVID-19

www.astrazeneca.com

 

[Supine]

I'm not reading anything into the 62%, 70% or 90% results to be honest. We are talking about such small amounts of data the numbers can jump lots just due to random chance. Same goes for the other two vaccines that show 90%+.

The good news is we have another candidate and it's cheaper and more available.

Great news for a monday morning

 

[teuchter]

I hadn't appreciated that these vaccinations might have no effect on whether you are liable to infect someone else.

Doesn't this potentially create a scenario where transmission actually increases? Because those who've had the vaccine will feel that there's no longer risk to themselves, and be more likely to be out and about. And, if you are seeing fewer people suffering significant symptoms but the same number of people infected overall, that's another tranche of people who would otherwise have stayed at home, out and about.

 

[bimble]

This is good. Might turn out to make a huge difference if it means that an effective vaccine will be copyright-free, might mean that there is something like an end in sight not just in rich countries.


and it only needs refrigeration at normal fridge temperatures, that is a massive advantage.

 

[cloudyday]

if vaccination is required more than once (over months, years or whatever). Does anyone know if you can mix them or do you have to stick with the one you started with?

 

[cupid_stunt]

This is good. Might turn out to make a huge difference if it means that an effective vaccine will be copyright-free, might mean that there is something like an end in sight not just in rich countries.

and it only needs refrigeration at normal fridge temperatures, that is a massive advantage.

Yeah, they always said it would be produced on a not-for-profit basis during the pandemic, but could still be very profitable afterwards.

COVID-19: The multi-billion pound business of the Oxford vaccine

A leading researcher on the vaccine insisted it was made not-for-profit during the pandemic, but could earn millions after.

news.sky.com

 

[Teaboy]

I hadn't appreciated that these vaccinations might have no effect on whether you are liable to infect someone else.

Doesn't this potentially create a scenario where transmission actually increases? Because those who've had the vaccine will feel that there's no longer risk to themselves, and be more likely to be out and about. And, if you are seeing fewer people suffering significant symptoms but the same number of people infected overall, that's another tranche of people who would otherwise have stayed at home, out and about.

Yes there are just so many unknowns at the moment. It seems to me the effectiveness of any vaccine in the most at risk groups is going to be critical.

 

[ignatious]

I hadn't appreciated that these vaccinations might have no effect on whether you are liable to infect someone else.

Doesn't this potentially create a scenario where transmission actually increases? Because those who've had the vaccine will feel that there's no longer risk to themselves, and be more likely to be out and about. And, if you are seeing fewer people suffering significant symptoms but the same number of people infected overall, that's another tranche of people who would otherwise have stayed at home, out and about.

The vaccines that are currently being trialled are only researching their effect on symptomatic disease (defined as a cough, fever, and positive PCR test). They are not looking into hospital admissions, ICU admissions or deaths. The effect of these vaccines on death rates and person-to-person asymptomatic transmission are therefore unknown. An overview of the trials and what they are aiming to achieve can be found on page two of this BMJ article.

It is possible that transmission will actually increase if life goes ‘back to normal’. In fact it seems quite likely if transmission is still possible even by those who’ve had the vaccine, and if there are no distancing measures in place.

 

[2hats]

Doesn't this potentially create a scenario where transmission actually increases?

Another good reason (not that one is needed) for vaccinating the elderly vulnerable first, and then healthcare staff, the vulnerable and then down the age cohorts...

if vaccination is required more than once (over months, years or whatever). Does anyone know if you can mix them or do you have to stick with the one you started with?

The research data to answer that question should be available in the next 2-5 years.

 

[LDC]

if vaccination is required more than once (over months, years or whatever). Does anyone know if you can mix them or do you have to stick with the one you started with?

Very theoretical question though, as any vaccines are going to be in short supply for a long while, so nobody is likely to be given multiple vaccines.

From my little knowledge it would depend on how each vaccine worked, and it might be possible to have multiple vaccines that work in different ways, but I wouldn't have though that would be an priority area for looking into currently. I'm on a vaccine trial and have been told that I will be able to have any other vaccine that comes into use, even if I have had the vaccine rather than the placebo in the trial if that's any indicator.

 

[prunus]

I hadn't appreciated that these vaccinations might have no effect on whether you are liable to infect someone else.

Doesn't this potentially create a scenario where transmission actually increases? Because those who've had the vaccine will feel that there's no longer risk to themselves, and be more likely to be out and about. And, if you are seeing fewer people suffering significant symptoms but the same number of people infected overall, that's another tranche of people who would otherwise have stayed at home, out and about.

It is possible but it’s not likely - the reason the scientists are stressing it is that in most cases the studies they are doing are not set up to test that - scientists are very precise. The differential dose arm of the OxAZ study is the only one where I’ve read that they were testing for anything like that (weekly tests of asymptomatic test subjects), and it suggested it did result in reduced transmission.

I’d bet if you could ask any of the scientists involved informally over a beer they would answer “well we don’t know because we haven’t looked but yeah I’m pretty sure it will reduce asymptomic transmission as well, and reduce asymptomatic case number too”

 

[2hats]

The majority of vaccines don't provide sterilising immunity (or strong degree thereof). Their main (or only) aim is disease prevention - eg TB, polio, various influenza - to reduce mortality, morbidity and complications. Some vaccines happen to also provide sterilising immunity - eg HPV, MMR, yellow fever.

 

[Sunray]

With three vaccines on the horizon. Especially with the Oxford Uni vaccine being stable at 4degC I really think back to normal is on the horizon. Although I read the NHS has supplied storage warehouses around the country with specialised freezers.

The UK already has 4 million doses of the Oxford vaccine already. If/When it's approved, health care workers can start to get vaccinations immediately.

 

[elbows]

I do not predict a return to 100% normality.

 

[bimble]

Yeah, they always said it would be produced on a not-for-profit basis during the pandemic, but could still be very profitable afterwards.

COVID-19: The multi-billion pound business of the Oxford vaccine

A leading researcher on the vaccine insisted it was made not-for-profit during the pandemic, but could earn millions after.

news.sky.com

i think this qualifies as a genuine good news item. In perpetuity is a long time.

 

[Wilf]

The issue as to whether the vaccines (don't) prevent onward transmission, along with the 70% headline figure, focuses everything right back onto uptake figures and resistance by anti-vacc twats. If a significant number of people who are of working age and socialising refuse the jab, everything gets very messy and the who thing drags on and on. Hopefully, if rational argument fails, self interest, gigs and holidays will push them towards the jab. It's going to be a bumpy ride though, with a spectacularly stupid and venal government in the driving seat.

By the by, anybody know how people will prove they've had the jab? Some kind of electronic add on to a driving licence? Phone app?

 

[LDC]

With three vaccines on the horizon. Especially with the Oxford Uni vaccine being stable at 4degC I really think back to normal is on the horizon. Although I read the NHS has supplied storage warehouses around the country with specialised freezers.

The UK already has 4 million doses of the Oxford vaccine already. If/When it's approved, health care workers can start to get vaccinations immediately.

Healthcare workers aren't first to get vaccinated. It's care home residents and workers first. Heakthcare workers next, although that might be concurrently depending on vaccine amounts that are available and the logistics of getting people actually jabbed.

When you say 'back to normal is on the horizon' if you mean some return to normality by next summer, then yes. More and sooner than that, no.

 

[LDC]

By the by, anybody know how people will prove they've had the jab? Some kind of electronic add on to a driving licence? Phone app?

It'll be a bar code tattoo on the forehead according to some...

Work based OH records for the first lots getting it I expect; care home residents and workers and healthcare workers. Rest would be GP records I expect. I don't think they'll be any proving you've had the vaccine though for anything, no matter what the newspapers say. I mean shops etc. can't even make people wear masks, no way is anything commercial like gigs or other events are going to be able to check medical records and prove things like valid medical exemptions for people who can't have the vaccine.

Wonder if some workplaces will make it compulsory? Healthcare and care homes could for staff for example.

 

[belboid]

Breaking news

Covid-19: Oxford University vaccine is highly effective

The vaccine is cheaper than other options and easier to distribute around the world.

www.bbc.co.uk

No need to thank me for saving the world

or 70% of it anyway

 

[belboid]

I am intrigued to know what I’ll be allowed to take - as I’ve been doing the Oxford trial since it started. I am meant to be on it for a year, so at least till next April, I can’t actually remember when I started it. I dont actually know if I had the vaccine or placebo (obvs) and they do need to continue studies to see if there are any longer term effects. But I’ll be pissed off if I can’t go on holiday/to gigs because I can’t provide proof I’ve been vaccinated.

 

[Teaboy]

Wonder if some workplaces will make it compulsory? Healthcare and care homes could for staff for example.

Its an interesting thought. A breakout in our factory is what scares our MD the most.

Flights would be the one place where I think where some sort of vaccine certificate may be used.

 

[teuchter]

The majority of vaccines don't provide sterilising immunity (or strong degree thereof). Their main (or only) aim is disease prevention - eg TB, polio, various influenza - to reduce mortality, morbidity and complications.

Now I'm confused because I'd understood that polio eradication is a result of vaccination reducing its opportunities for transmission.