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Vaccine- who will have it?


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15 minutes ago, Banker said:

Patrick valance clarified gap in doses as the headlines are misleading 

Vallance on vaccine dose questions

Here is Sir Patrick's response to questions around the efficacy of the first Pfizer vaccine dose – including a crucial detail around how the approximate 50% protection figure was arrived at.

He points out that it is a figure that takes in results from day 0 to 28 – and, importantly, that "you don’t expect to get any protection" in the first 10 days.

The clear implication is that numbers from the 0-10 days period is dragging that protection figure down to around 50% - when the true figure from 10-21 days and beyond is closer to the 89% found by clinical trials.

Cheers for that. Explains a lot of contrary information going around. Very important information.

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It was quite revealing when at one of the briefings last week he spent quite a while explaining how the IOM's clinicians had debated whether to extend the period between doses, and it was a consensus

Who is talking about setting up in a cowshed?  There are plenty of nice, warm venues large enough to do this on the IOM without OTT adaptations.  

Always something to moan about.  Can’t you just be grateful that you live here and not, virtually, anywhere else in the world.  Last time I looked the UK/CI/IOM were streets ahead of the rest of the w

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9 minutes ago, Banker said:

Patrick valance clarified gap in doses as the headlines are misleading 

Vallance on vaccine dose questions

Here is Sir Patrick's response to questions around the efficacy of the first Pfizer vaccine dose – including a crucial detail around how the approximate 50% protection figure was arrived at.

He points out that it is a figure that takes in results from day 0 to 28 – and, importantly, that "you don’t expect to get any protection" in the first 10 days.

The clear implication is that numbers from the 0-10 days period is dragging that protection figure down to around 50% - when the true figure from 10-21 days and beyond is closer to the 89% found by clinical trials.

The trouble with that is that is you keep on analysing smaller and smaller subsamples of data, you end up with great uncertainty over what the true value is.  So that 89% has a 'confidence interval' of 52% - 97% it's that uncertain.

But as that BMJ letter also points out, the real problem is that we have no evidence for how a single-dose protects people beyond that period.  It may well be that without a booster protection begins to fall off, and with too long a gap the second one, when it is eventually administered, may then be less effective.  There's no evidence available.

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I think by sticking to the published trial protocols we’ll be doing it right. I’ve read the analysis which justifies the UK’s single dose strategy and it is basically saying that in the trials the majority of infections in the treated group occurred in the first 7-10 days, where there would be little to no protection expected. It’s at about Day 10 that the curves from the placebo and treated groups diverge. Efficacy from day 14-28 which is before the time the second dose kicks in is 90% or thereabouts. 
 

Two problems though. Numbers are small, so confidence intervals are wide. And it’s impossible to say, apart from by guesswork or assumption from other vaccines, what the efficacy is from 28 days onwards. 
 

Until there is some real world data from countries doing a single dose strategy I’d vote we stick to the plan. 

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1 hour ago, manxst said:

“it is something our clinical group have been looking at” sounds like exactly what the headline says? 

What he really meant to say was, "we've just received an email from PHE and we should regurgitate the following.....".

He's a very good master of bullshit. He wouldn't last five minutes on "Just a Minute".

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4 minutes ago, Andy Onchan said:

 

He's a very good master of bullshit. He wouldn't last five minutes on "Just a Minute".

So he’d trounce Paul Merton et al, doing 5 minutes ;)

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17 minutes ago, Andy Onchan said:

What he really meant to say was, "we've just received an email from PHE and we should regurgitate the following.....".

He's a very good master of bullshit. He wouldn't last five minutes on "Just a Minute".

Wonder how Ashie, Howie etc would cope with an Andrew Marr interview!!

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9 minutes ago, Banker said:

Wonder how Ashie, Howie etc would cope with an Andrew Marr interview!!

Priti Patel got a harsh (deservedly so) run this morning by that weasel Piers Morgan, like him or loathe him he will not put up with bullshit answers.

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1 hour ago, piebaps said:

You mean that we might be doing it right after all? Surely not!!

The strategy should certainly work well for those lucky enough to get 2 doses at a 21 day interval. It won't work as well for those vulnerable individuals that remain unvaccinated for a lot longer due to a lack of vaccine. It all depends on the supply of vaccine available in the early stages of the roll out.

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Sorry, but if the efficacy rate was 89% with one dose, or anywhere near, Pfizer would not have been recommending a second dose. Normal flu vaccine, single dose has an efficacy rate of 60-70%. 

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Surely if you leave a long enough gap between the first and second doses, there is a chance that the body will treat the second dose as if it is another first dose?

If the manufacturers have recommended a 21 day gap, rather than any longer, they must have valid reasons? 

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15 minutes ago, monasqueen said:

Surely if you leave a long enough gap between the first and second doses, there is a chance that the body will treat the second dose as if it is another first dose?

If the manufacturers have recommended a 21 day gap, rather than any longer, they must have valid reasons? 

That's right. That's because what they recommend is the 'optimum' gap. The trouble humanity has at the moment is deciding between a number of people having the optimum application of the vaccine (and lots having nothing)or double that number having a slightly less than optimum protection. In an emergency you might go for the latter.

The downside of the latter, as you say, is you might waste the whole of the first vaccinations and have to start again. The upside is you might save lots of lives and reduce the pandemic.

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I've been crtical of the vaccination programme, so far, especially the pedestrian pace and lack of any obvious urgency.

So to add a bit of balance, a family member 80+, who got a letter last week and on calling 111 was told there were no appointments available, has now had a phone call offering a slot next Tuesday (26th Jan) with a second one on (16th Feb).

Assuming that they are not a 'one-off', that does seem to suggest that they have opened up near term slots which weren't available a few days ago. Hopefully this reflects a bit more urgency being injected into the process (pun intended!). 

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