Possible vaccines/treatment(s) for Coronavirus

[elbows]

By the way I would consider the mink strain scare as being something of a preview of one possible future scenario where vaccination leads to selection pressure when it comes to how the virus evolves. ie strains that randomly mutate in a way that just happens to bypass the immune responses generated by initial vaccines will end up with a big advantage that leads to them becoming the dominant strain.

I dont think such a scenario is completely inevitable but in theory its a real risk and it will be an area of concern in the covid vaccine era.

 

[2hats]

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

Polio has not entirely been eradicated; there are still routes/incidences of transmission. Indeed the polio vaccination programme takes advantage of some degree of transmission in order to help promote community immunity.

There are two types of polio vaccine in use:

• Sabin (oral) - attenuated live virus.
• Salk (intramuscular) - inactivated.

The former vaccine does promote sterilising immunity (as well as immunity from disease and, almost uniquely, contact immunity); however it can occasionally promote vaccine derived poliovirus strains and poliomyelitis itself. The latter vaccine only provides immunity from disease (but with no risk of either promoting vaccine derived poliovirus strains or poliomyelitis).

More generally - attenuated live virus based vaccines tend to promote both sterilising immunity, because the immune system of the patient experiences something akin to the full infection cycle, and tend to be longer lasting as a result (many years to lifetime). Also, in part, because they tend to be ones that are administered orally/nasally.

 

[Sunray]

I do not predict a return to 100% normality.

Your reasoning? If the vaccine works and doesn't make us sick, the pandemic ends. We can do all the things we were doing.
Vaccinate rapidly enough and it also ends the virus, no hosts so it can't replicate.

We can genuinely wave goodbye to Covid-19, maybe figure out how to respond to pandemics in the future.

 

[frogwoman]

As people can get reinfected I'm guessing we will need to get vaccinated every year or so

 

[editor]

As people can get reinfected I'm guessing we will need to get vaccinated every year or so

That would be a small price to pay, all things considered.

 

[frogwoman]

I'm guessing we'll get letters saying when it is due etc. I don't think I've ever looked forward to an injection so much

 

[frogwoman]

Vaccinated Siberian Medics Get Coronavirus - The Moscow Times

At least three medics who received Russia’s vaunted Sputnik V vaccine have contracted the coronavirus in Siberia as part of a vaccination drive of at-risk groups, regional authorities said Tuesday.

www.themoscowtimes.com

really hope this is a once-off

 

[weltweit]

I heard AstraZeneca plan to distribute their vaccine at cost.

 

[prunus]

Vaccinated Siberian Medics Get Coronavirus - The Moscow Times

At least three medics who received Russia’s vaunted Sputnik V vaccine have contracted the coronavirus in Siberia as part of a vaccination drive of at-risk groups, regional authorities said Tuesday.

www.themoscowtimes.com

really hope this is a once-off

Well it’s a thrice-off just here - but the claim that the immunity hadn’t had time to develop is entirely plausible (though not checkable with the information given).

It takes I believe 6 weeks for immunity to develop (from the first inoculation I think) in the western studies - this doesn’t seem to be being emphasised; I think should be being shouted from the rooftops, as otherwise loads of people are going to get jabbed and go straight back to ‘normal’, with attendant risks.

Also - none of the vaccines are 100% effective (and I don’t think data has been released on the Russian one) - some people are going to get it anyway, and some of them are going to die. Hopefully not very many.

 

[frogwoman]

I guessed around a few days or so?

 

[2hats]

Your reasoning? If the vaccine works and doesn't make us sick, the pandemic ends. We can do all the things we were doing.
Vaccinate rapidly enough and it also ends the virus, no hosts so it can't replicate.

We can genuinely wave goodbye to Covid-19, maybe figure out how to respond to pandemics in the future.

Top tip: try starting reading a little further back in the thread (say, about 2 pages or so). Mix in a little mutation, selection and degree of efficacy too.

 

[elbows]

Your reasoning? If the vaccine works and doesn't make us sick, the pandemic ends. We can do all the things we were doing.
Vaccinate rapidly enough and it also ends the virus, no hosts so it can't replicate.

We can genuinely wave goodbye to Covid-19, maybe figure out how to respond to pandemics in the future.

I'm just not much into seeing things in terms of magic bullets, so its inevitable that I will take a cautious approach and wait and see.

Vaccines should be a game changer, but that still doesn't mean 100% normality to me, but we will just have to wait and see. Plus absolute normality means different things to different people, and given for example the stuff going on with energy and climate, what's normal is bound to change rather a lot over the coming decades. I sort of expect that certain things peaked and will never quite return to pre-pandemic levels, but thats not just because of the virus, it will be interplay between the situations and changes the pandemic caused, and energy and economic stuff.

 

[elbows]

Top tip: try starting reading a little further back in the thread (say, about 2 pages or so). Mix in a little mutation, selection and degree of efficacy too.

Yes that stuff too. My expectations with those things currently have a rather broad range so I have no specific predictions to make, other than a general expectation that there will be setbacks of some kind at some point.

 

[frogwoman]

Well it’s a thrice-off just here - but the claim that the immunity hadn’t had time to develop is entirely plausible (though not checkable with the information given).

It takes I believe 6 weeks for immunity to develop (from the first inoculation I think) in the western studies - this doesn’t seem to be being emphasised; I think should be being shouted from the rooftops, as otherwise loads of people are going to get jabbed and go straight back to ‘normal’, with attendant risks.

Also - none of the vaccines are 100% effective (and I don’t think data has been released on the Russian one) - some people are going to get it anyway, and some of them are going to die. Hopefully not very many.

Yeah the time frame hasn't been emphasised at all. I thought it was a few days at most.

 

[William of Walworth]

I'm quite surprised that this thread hasn't moved all that much today .....

Some more detail about the Oxford/AstraZeneca vaccine :

The 90% efficacy rather than the 70% efficacy -- some details

A bit more about the half-doses turning out to be possibly more effective than the full doses, initially

I'm sure there are better and more hard-core-sciencey articles around, but my search about Oxford stuff was quick for reasons

 

[Wilf]

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.

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

I can see the government might see the need for some kind of official or semi official proof of vaccination, purely for economic reasons. Presumably there may be international agreements at some point about needing certification for air travel. At the other end of the scale I've seen ticketing agencies talking about wanting to see proof of a vaccination or recent negative test before allowing access to a gig. Just about the last thing the NHS or country needs are people getting random tests just to go and watch a tribute acts night at some local O2 academy, so there will be pressure for some kind of longer term proof of vaccination.

 

[William of Walworth]

I'm quite surprised that this thread hasn't moved all that much today .....
Some more detail about the Oxford/AstraZeneca vaccine :
The 90% efficacy rather than the 70% efficacy -- some details
A bit more about the half-doses turning out to be possibly more effective than the full doses, initially
I'm sure there are better and more hard-core-sciencey articles around, but my search about Oxford stuff was quick for reasons

And even in same day's Guardian, there was a better/more detailed article about the Oxford/AstraZeneca vaccine :

Vaccine results bring us a step closer to ending Covid, says Oxford scientist

Looks like various professionals are positive about it, including this Doctor :

Dr Richard Hatchett, the chief executive of the Coalition for Vaccine Preparedness (CEPI) which is involved in Covax**, said they believed the Oxford vaccine “has the potential to significantly alter the course of the global pandemic. The data released today suggest the vaccine is safe and comparable in its efficacy to other licensed vaccines – including influenza – that are widely used to protect people around the world today.”

** Covax, the World Health Organization-led programme to distribute vaccines to all countries

 

[2hats]

There are issues with the Oxford/Astrazeneca study. Incomplete/inadequate data and question marks over the trial plans (modifying them on the fly is highly unusual).

The AstraZeneca Covid Vaccine Data Isn't Up to Snuff

There's been even more good news this week, this time from the Oxford-AstraZeneca trials. But a closer look reveals some very shaky science.

www.wired.com

The sub-group study with apparent 90% efficacy was only composed of 18-55 year olds and the low number of cases in that arm obviously raise questions as to how robust that 90% is.

Science | AAAS

www.sciencemag.org

None of three front runners have published all their trial data yet.

In short: more work needed.

 

[frogwoman]

What other data do they need? Is it just more examples of people being exposed to COVID-19? These are just preliminary results tho and more data needs to be published, but I thought this was known from the start?

 

[Supine]

There are issues with the Oxford/Astrazeneca study. Incomplete/inadequate data and question marks over the trial plans (modifying them on the fly is highly unusual).

The AstraZeneca Covid Vaccine Data Isn't Up to Snuff

There's been even more good news this week, this time from the Oxford-AstraZeneca trials. But a closer look reveals some very shaky science.

www.wired.com

The sub-group study with apparent 90% efficacy was only composed of 18-55 year olds and the low number of cases in that arm obviously raise questions as to how robust that 90% is.

Science | AAAS

www.sciencemag.org

None of three front runners have published all their trial data yet.

In short: more work needed.

I was about to post that. Interesting read - I'll be keen to see some expert opinion on this stuff.

 

[Sunray]

Here is an excellent podcast on the subject. Some heavily involved people making these vaccines are getting excited.

A vaccine revolution – podcast

With the race now on for regulatory approval, production and distribution of three vaccine candidates, is the end of the pandemic within reach?

www.theguardian.com

 

[belboid]

There are issues with the Oxford/Astrazeneca study. Incomplete/inadequate data and question marks over the trial plans (modifying them on the fly is highly unusual).

The AstraZeneca Covid Vaccine Data Isn't Up to Snuff

There's been even more good news this week, this time from the Oxford-AstraZeneca trials. But a closer look reveals some very shaky science.

www.wired.com

The sub-group study with apparent 90% efficacy was only composed of 18-55 year olds and the low number of cases in that arm obviously raise questions as to how robust that 90% is.

Science | AAAS

www.sciencemag.org

None of three front runners have published all their trial data yet.

In short: more work needed.

Yeah, the group I signed up for was in the 18-55 range, with a new group only added about two months ago. That was also when I got offered a second shot, about three months after the first one, so not within the recommended period. All the trials are highly unusual though, as you don't normally get a willing set of volunteers on a sufficient scale, and it would be unethical to not allow them (us) an apparently safer version of the treatment.

The doctor I saw this week was saying not to expect anything too quickly still, working out the correct first shot dosage still needs a fair bit of work.

 

[2hats]

What other data do they need? Is it just more examples of people being exposed to COVID-19? These are just preliminary results tho and more data needs to be published, but I thought this was known from the start?

Sufficient data for the conclusions to be statistically robust and reproducible, rather than of a standard adequate for feeding press releases?

 

[mx wcfc]

I'm guessing we'll get letters saying when it is due etc. I don't think I've ever looked forward to an injection so much

There was a GP on the local news earlier today telling people to make sure their doctor has up to date contact details, but especially a mobile phone number. They want to be able to text everyone. Quicker and cheaper.

I get text reminders about the flu jab and appointments, all automated.

 

[LDC]

I can see the government might see the need for some kind of official or semi official proof of vaccination, purely for economic reasons. Presumably there may be international agreements at some point about needing certification for air travel. At the other end of the scale I've seen ticketing agencies talking about wanting to see proof of a vaccination or recent negative test before allowing access to a gig. Just about the last thing the NHS or country needs are people getting random tests just to go and watch a tribute acts night at some local O2 academy, so there will be pressure for some kind of longer term proof of vaccination.

For international travel I've worked in places where they need to see a proof of Yellow Fever vaccination, so it won't be totally new to need proof of a vaccination for entry to a country.

I am optimistic about vaccines from what I've read, and am far from an anti-vaxxer, but I do have a slight concern that there's huge pressure to get them out, and I wonder if that will be a problem, less for safety and more for efficacy. Especially as the messaging pushed seems to be that they're the route 'back to normality' (urgh) even though plenty of people have made clear it's not as simple as that.

 

[LDC]

The anti-vaxxer at work (NHS) I mentioned on here somewhere was getting stressed about whether they'd make it compulsory for healthcare workers. I wonder... You already have to have some (Hepititis), so it would be possible and wouldn't be entirely a new thing. Although it'd be harder for current employees maybe due to employment law/contracts, but new ones it could be made part of the contract more easily possibly?

 

[William of Walworth]

2hats , and also elbows and other science-aware Urbans :

I have far from enough science awareness to really understand whether or not that Wired article (linked to by 2hats above) wrecks the Oxford/Astra/Zeneca vaccine project?

 

[frogwoman]

Don't think it wrecks it no but I don't think that's what the article is saying

 

[elbows]

Well its the sort of story that reminds me why I take a cautious approach, let others do the quick analysis, and play the long game in terms of how long it takes for me to form opinions about medicines and vaccines. And why I generally have a sneery attitude towards press releases. And why I dont generally believe in silver bullets, even when vaccines probably have the ability to be a game changer even if not quite the game ender some seem too tempted to imagine.

I dont mind reading the detail about vaccines but I am not confident enough about the subject to consider trying to speak with authority on the subject often, especially not when it comes to the detail of specific vaccines. Maybe there will be a time where I attempt to get properly clued up about all the tedious detail of a particular vaccine, but this isn't it, I'll be content to watch others weed out the field a bit first.

 

[2hats]

There are other concerns besides the paucity of data in older cohorts and failure to stick to the trial design, including: relatively small trial participant numbers, that subgroup analyses are likely to be less precise and can be prone to error, and of the limited ethnic diversity of sub-group trial participants. These are interim results and the figures quoted thus far may well change, could even change substantially (in either direction).

There are unanswered questions like: over time (ie repeated boosters) the viral vector used here may prompt an immune response reducing the efficacy of the vaccine (this may have been what was being observed in the sub-group who received the two standard doses and only saw about 62% efficacy) - that might necessitate regular reformulation with different vector serotypes (cf. the Russian Sputnik V, is reported to use two different serotypes for the prime and the booster doses; is now claiming >95% efficacy).

Nothing is 'wrecked'. It simply needs more work. Full, thorough vaccine trials unsurprisingly take time to collect adequate, high quality data, produce results we can trust, from which conclusions can be drawn and upon which decisions can be made.